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Suzuki K, Miyamoto K, Kanai T, Kurihara M, Kikuchi K, Harano K, Kato A, Yagi M, Ohgiya Y, Dohi K. Single-photon emission computed tomography (SPECT) predicted neurological prognosis in heat stroke: A case report. Heliyon 2023; 9:e18285. [PMID: 37539227 PMCID: PMC10393623 DOI: 10.1016/j.heliyon.2023.e18285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/29/2023] [Accepted: 07/13/2023] [Indexed: 08/05/2023] Open
Abstract
Heat stroke may cause multi-organ dysfunction and death. Some patients with neurological abnormalities in the acute phase have neurological sequelae, particularly cerebellar ataxia, in the recovery phase. However, there is no method to predict the neurological prognosis, and the usefulness of imaging has not yet been established. We report the case of an 86-year-old woman with dementia brought to our emergency department in a coma and hyperthermia. The patient was diagnosed with heat stroke and promptly treated in the ICU but remained unconscious. The patient gained consciousness on day 19, but difficulty with stillness associated with cerebellar ataxia in her right upper extremity became apparent. On day 1, head magnetic resonance imaging (MRI) showed no obvious abnormality. However, on day 6, high-signal areas, suggestive of edema, were seen in the bilateral cerebellar hemispheres. Single-photon emission computed tomography (SPECT) on day 9 revealed significant hypoperfusion in the right cerebellum. These changes improved at the time of hospital discharge. This was a case of persistent cerebellar ataxia due to heat stroke, in which imaging findings improved over time. In most cases, MRI findings do not match clinical symptoms. However, the low cerebral blood flow in the early SPECT images was consistent with the clinical symptoms. MRI may not be a prognostic indicator; however, SPECT images may be useful for predicting sequelae.
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Affiliation(s)
- Keisuke Suzuki
- Department of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
- Department of Radiology, Division of Radiology, Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Kazuyuki Miyamoto
- Department of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Takahiro Kanai
- Department of Radiology, Division of Radiology, Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Mariko Kurihara
- Department of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Kazuki Kikuchi
- Department of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Kohei Harano
- Department of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Akihito Kato
- Department of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
- Department of Emergency and Disaster Medicine, Showa University, Yokohama Northern Hospital, 35-1 Chigasaki Chuo Tsuzuki-ku, Yokohama 224-8503, Japan
| | - Masaharu Yagi
- Department of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Yoshimitsu Ohgiya
- Department of Radiology, Division of Radiology, Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Kenji Dohi
- Department of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
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Kaga T, Kato H, Imai T, Ando T, Noda Y, Miura T, Enomoto Y, Hyodo F, Iwama T, Matsuo M. Non-invasive regional cerebral blood flow quantification in the 123I-IMP autoradiography using artificial neural network. PLoS One 2023; 18:e0281958. [PMID: 36888603 PMCID: PMC9994717 DOI: 10.1371/journal.pone.0281958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 02/04/2023] [Indexed: 03/09/2023] Open
Abstract
PURPOSE Regional cerebral blood flow (rCBF) quantification using 123I-N-isopropyl-p-iodoamphetamine (123I-IMP) requires an invasive, one-time-only arterial blood sampling for measuring the 123I-IMP arterial blood radioactivity concentration (Ca10). The purpose of this study was to estimate Ca10 by machine learning (ML) using artificial neural network (ANN) regression analysis and consequently calculating rCBF and cerebral vascular reactivity (CVR) in the dual-table autoradiography (DTARG) method. MATERIALS AND METHODS This retrospective study included 294 patients who underwent rCBF measurements through the 123I-IMP DTARG. In the ML, the objective variable was defined by the measured Ca10, whereas the explanatory variables included 28 numeric parameters, such as patient characteristic values, total injection 123I-IMP radiation dose, cross-calibration factor, and the distribution of 123I-IMP count in the first scan. ML was performed with training (n = 235) and testing (n = 59) sets. Ca10 was estimated in testing set by our proposing model. Alternatively, the estimated Ca10 was also calculated via the conventional method. Subsequently, rCBF and CVR were calculated using estimated Ca10. Pearson's correlation coefficient (r-value) for the goodness of fit and the Bland-Altman analysis for assessing the potential agreement and bias were performed between the measured and estimated values. RESULTS The r-value of Ca10 estimated by our proposed model was higher compared with the conventional method (0.81 and 0.66, respectively). In the Bland-Altman analysis, mean differences of 4.7 (95% limits of agreement (LoA): -18-27) and 4.1 (95% LoA: -35-43) were observed using proposed model and the conventional method, respectively. The r-values of rCBF at rest, rCBF after the acetazolamide challenge, and CVR calculated using the Ca10 estimated by our proposed model were 0.83, 0.80 and 0.95, respectively. CONCLUSION Our proposed ANN-based model could accurately estimate the Ca10, rCBF, and CVR in DTARG. These results would enable non-invasive rCBF quantification in DTARG.
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Affiliation(s)
- Tetsuro Kaga
- Department of Radiology, Gifu University, Gifu, Japan
- * E-mail:
| | - Hiroki Kato
- Department of Radiology, Gifu University, Gifu, Japan
| | - Toyohiro Imai
- Department of Radiology Services, Gifu University Hospital, Gifu, Japan
| | - Tomohiro Ando
- Department of Radiology, Gifu University, Gifu, Japan
| | | | - Takayuki Miura
- Department of Radiology Services, Gifu University Hospital, Gifu, Japan
| | - Yukiko Enomoto
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Fuminori Hyodo
- Department of Radiology, Frontier Science for Imaging, Gifu University, Gifu, Japan
| | - Toru Iwama
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan
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Kunitake K, Ogura A, Iwata-Hatanaka M, Inagaki R, Furukawa S, Suzuki J, Nakai N, Nishida S, Katsuno M, Ito Y. Persistent brain damage in reversible cerebral vasoconstriction syndrome on 99mTc-ethyl cysteinate dimer single-photon emission computed tomography: A long-term observational study. J Neurol Sci 2022; 442:120441. [PMID: 36209569 DOI: 10.1016/j.jns.2022.120441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 08/24/2022] [Accepted: 09/25/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Blood-brain barrier (BBB) breakdown is considered a key step in the pathophysiology of reversible cerebral vasoconstriction syndrome (RCVS); however, its temporal course remains unclear. Based on the characteristics and dynamics of 99mTc-ethyl cysteinate dimer (99mTc-ECD) as a tracer, 99mTc-ECD single-photon emission computed tomography (SPECT) can detect not only hypoperfusion but also BBB breakdown and/or brain tissue damage. Therefore, this study aimed to investigate this course using 99mTc-ECD SPECT. METHODS Between 2011 and 2019, we enrolled seven patients (one male and six female patients) with RCVS without ischemic or hemorrhagic stroke or posterior reversible encephalopathy syndrome. 99mTc-ECD SPECT was performed repeatedly in each patient. SPECT data were statistically analyzed using an easy Z-score imaging system. RESULTS Thunderclap headache was the initial symptom in all the patients and was most commonly triggered by bathing (three patients). All the patients exhibited vasoconstriction and reduced cerebral uptake of 99mTc-ECD during the acute stage. Follow-up assessment from 3 to 16 months showed that reduced cerebral uptake persisted in all the patients, even after the vasoconstriction had resolved. CONCLUSION Reduced cerebral uptake of 99mTc-ECD persisted in the late stage of RCVS, even after vasoconstriction and headache subsided. BBB breakdown and/or brain tissue damage may underlie this phenomenon. 99mTc-ECD SPECT is an effective neuroimaging method to detect brain functional abnormalities, reflecting BBB breakdown or tissue damages, throughout the treatment course of RCVS.
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Affiliation(s)
- Katsuhiko Kunitake
- Department of Neurology, TOYOTA Memorial Hospital, Toyota, Aichi, Japan; Department of Molecular Therapy, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo, Japan; Department of NCNP Brain Physiology and Pathology, Graduate school of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo, Tokyo, Japan.
| | - Aya Ogura
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Mai Iwata-Hatanaka
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Ryosuke Inagaki
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Soma Furukawa
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Junichiro Suzuki
- Department of Neurology, TOYOTA Memorial Hospital, Toyota, Aichi, Japan
| | - Noriyoshi Nakai
- Department of Neurology, TOYOTA Memorial Hospital, Toyota, Aichi, Japan
| | - Suguru Nishida
- Department of Neurology, Nishichita General Hospital, Tokai, Aichi, Japan
| | - Masahisa Katsuno
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yasuhiro Ito
- Department of Neurology, TOYOTA Memorial Hospital, Toyota, Aichi, Japan
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Usefulness of dual isotope 123I-IMP and 201Tl SPECT for the diagnosis of primary central nervous system lymphoma and glioblastoma. Int J Clin Oncol 2022; 27:1264-1272. [PMID: 35554754 DOI: 10.1007/s10147-022-02171-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/20/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Preoperative differential diagnosis between primary central nervous system lymphoma (PCNSL) and glioblastoma (GBM) is important because these tumors require different surgical strategies. This study investigated the usefulness of dual isotope, iodine-123-labeled N-isopropyl-p-iodo-amphetamine (123I-IMP) and thallium-201 chloride single-photon emission computed tomography (201Tl SPECT) for the differential diagnosis. METHODS Twenty-five PCNSL patients and 27 GBM patients who underwent dual isotope imaging, 123I-IMP and 201Tl SPECT, are included. Tumor-to-normal (T/N) ratio was calculated from the ratio of maximum tracer counts in the lesion to the mean counts in the contralateral cerebral cortex. The mean and minimum apparent diffusion coefficient values (ADCmean and ADCmin, respectively) on magnetic resonance imaging were also analyzed. RESULTS Delayed phase 123I-IMP SPECT was the most useful imaging examination for the differentiation between PCNSL and GBM compared with early phase 123I-IMP SPECT, early and delayed phase 201Tl SPECT, ADCmean, and ADCmin. However, the median T/N ratios of PCNSL and GBM were 1.32 and 0.83, respectively, in the delayed phase 123I-IMP SPECT. On the other hand, the median T/N ratios of PCNSL and GBM were 3.10 and 2.34, respectively, in the delayed phase 201Tl SPECT, with excellent tumor detection. CONCLUSION Delayed phase 123I-IMP SPECT could differentiate between PCNSL and GBM with high accuracy, but T/N ratio was low and tumor detection was poor. 201Tl SPECT was useful for estimation of the malignancy and localization of the tumors with high T/N ratio. Dual isotope 123I-IMP and 201Tl SPECT was useful for the preoperative diagnosis of PCNSL and GBM.
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Nakano Y, Hirano S, Kojima K, Li H, Sakurai T, Suzuki M, Tai H, Furukawa S, Sugiyama A, Yamanaka Y, Yamamoto T, Iimori T, Yokota H, Mukai H, Horikoshi T, Uno T, Kuwabara S. Dopaminergic Correlates of Regional Cerebral Blood Flow in Parkinsonian Disorders. Mov Disord 2022; 37:1235-1244. [DOI: 10.1002/mds.28981] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/31/2022] [Accepted: 02/06/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
- Yoshikazu Nakano
- Department of Neurology Graduate School of Medicine, Chiba University Chiba Japan
- Department of Neurology Chibaken Saiseikai Narashino Hospital Narashino Japan
| | - Shigeki Hirano
- Department of Neurology Graduate School of Medicine, Chiba University Chiba Japan
| | - Kazuho Kojima
- Department of Neurology Graduate School of Medicine, Chiba University Chiba Japan
- Department of Neurology Chiba Rosai Hospital Ichihara Japan
| | - Honglinag Li
- Department of Neurology Graduate School of Medicine, Chiba University Chiba Japan
| | - Toru Sakurai
- Department of Neurology Graduate School of Medicine, Chiba University Chiba Japan
| | - Masahide Suzuki
- Department of Neurology Graduate School of Medicine, Chiba University Chiba Japan
| | - Hong Tai
- Department of Neurology Graduate School of Medicine, Chiba University Chiba Japan
| | - Shogo Furukawa
- Department of Neurology Graduate School of Medicine, Chiba University Chiba Japan
- Department of Neurology Japanese Red Cross Narita Hospital Narita Japan
| | - Atsuhiko Sugiyama
- Department of Neurology Graduate School of Medicine, Chiba University Chiba Japan
| | - Yoshitaka Yamanaka
- Department of Neurology Graduate School of Medicine, Chiba University Chiba Japan
| | - Tatsuya Yamamoto
- Department of Neurology Graduate School of Medicine, Chiba University Chiba Japan
- Division of Occupational Therapy, Department of Rehabilitation Chiba Prefectural University of Health Sciences Chiba Japan
| | - Takashi Iimori
- Department of Radiology Chiba University Hospital Chiba Japan
| | - Hajime Yokota
- Diagnostic Radiology and Radiation Oncology Graduate School of Medicine, Chiba University Chiba Japan
| | - Hiroki Mukai
- Department of Radiology Chiba University Hospital Chiba Japan
| | | | - Takashi Uno
- Diagnostic Radiology and Radiation Oncology Graduate School of Medicine, Chiba University Chiba Japan
| | - Satoshi Kuwabara
- Department of Neurology Graduate School of Medicine, Chiba University Chiba Japan
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6
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Tripathi M. Gamma camera imaging in ischemic diseases of CNS. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00192-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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7
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Uwano I, Kobayashi M, Setta K, Ogasawara K, Yamashita F, Mori F, Matsuda T, Sasaki M. Assessment of Impaired Cerebrovascular Reactivity in Chronic Cerebral Ischemia using Intravoxel Incoherent Motion Magnetic Resonance Imaging. J Stroke Cerebrovasc Dis 2021; 30:106107. [PMID: 34562793 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 08/10/2021] [Accepted: 09/04/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The severity of chronic cerebral ischemia can be assessed using cerebrovascular reactivity (CVR) to acetazolamide (ACZ) challenge, which is measured by single-photon emission computed tomography (SPECT); however, this is an invasive method. We investigated whether intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) can assess impaired CVR in preoperative patients with chronic cerebral ischemia and compared it to SPECT-CVR. METHODS Forty-seven patients with unilateral cervical carotid artery stenosis underwent diffusion-weighted MRI with 11 b-values in the range of 0-800 s/mm2 and cerebral perfusion SPECT with the ACZ challenge. The perfusion fraction (f) and diffusion coefficient (D) of the IVIM parameters were calculated using a bi-exponential model. The f and D values and these ratios of the ipsilateral middle cerebral artery territory against the contralateral side were compared with the CVR values of the affected side calculated from the SPECT data. RESULTS The IVIM-f and D values in the affected side were significantly higher than those in the unaffected side (median: 7.74% vs. 7.45%, p = 0.027; 0.816 vs. 0.801 10-3mm2/s, p < 0.001; respectively). However, there were no significant correlations between the f or D values and SPECT-CVR values in the affected side. In contrast, the f ratio showed a moderate negative correlation with the SPECT-CVR values (r = -0.40, p = 0.006) and detected impaired CVR (< 18.4%) with a sensitivity/specificity of 0.71/0.90. CONCLUSION The IVIM perfusion parameter, f, can noninvasively assess impaired CVR with high sensitivity and specificity in patients with unilateral cervical carotid artery stenosis.
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Affiliation(s)
- Ikuko Uwano
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, 1-1-1 Idai-dori, Yahaba, Iwate 028-3694, Japan.
| | - Masakazu Kobayashi
- Department of Neurosurgery, Iwate Medical University, Yahaba, Iwate, Japan
| | - Kengo Setta
- Department of Neurosurgery, Iwate Medical University, Yahaba, Iwate, Japan
| | - Kuniaki Ogasawara
- Department of Neurosurgery, Iwate Medical University, Yahaba, Iwate, Japan
| | - Fumio Yamashita
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, 1-1-1 Idai-dori, Yahaba, Iwate 028-3694, Japan
| | - Futoshi Mori
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, 1-1-1 Idai-dori, Yahaba, Iwate 028-3694, Japan
| | - Tsuyoshi Matsuda
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, 1-1-1 Idai-dori, Yahaba, Iwate 028-3694, Japan
| | - Makoto Sasaki
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, 1-1-1 Idai-dori, Yahaba, Iwate 028-3694, Japan
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Kanetaka H, Shimizu S, Inagawa Y, Hirose D, Takenoshita N, Sakurai H, Hanyu H. Differentiating Mild Cognitive Impairment, Alzheimer's Disease, and Dementia With Lewy Bodies Using Cingulate Island Sign on Perfusion IMP-SPECT. Front Neurol 2020; 11:568438. [PMID: 33329310 PMCID: PMC7710855 DOI: 10.3389/fneur.2020.568438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 10/21/2020] [Indexed: 12/30/2022] Open
Abstract
The cingulate island sign (CIS) on fludeoxyglucose (FDG)-positron emission tomography (PET) is a supporting biomarker of dementia with Lewy bodies (DLB). Its diagnostic accuracy has only been investigated in FDG-PET, however. The present prospective study compared the CIS on I-iodoamphetamine-single photon emission computed tomography (SPECT) among patients with mild cognitive impairment (MCI), AD, or DLB. Fifty-eight patients with MCI, 42 with probable AD, and 58 with probable DLB were enrolled. The "CIScore" used to evaluate the CIS was defined as the ratio of volume of interest (VOI)-1 (indicating posterior cingulate gyrus [PCG]) to VOI-2 (area of significantly reduced regional cerebral blood perfusion [rCBF] in DLB patients compared with in healthy controls). It was calculated using eZIS software. The CIScore for MCI, DLB, and AD was 0.22, 0.23, and 0.28, respectively. The CIScore in the AD group was significantly higher than that in the DLB or MCI groups (AD vs. DLB: p < 0.001, AD vs. MCI: p < 0.005). This suggests that the CIScore can discriminate DLB from AD, if the decrease in rCBF in the PCG is similar between them. We believe that it is difficult to identify MCI based on the CIScore, as the decrease in rCBF in the PCG is not severe. The diagnostic accuracy of the CIScore may be low as it often shows an increase in elderly DLB patients, in whom the pathologically common form is most prevalent (1). Further study should include assessment of multiple components such as symptom classification and age.
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Affiliation(s)
- Hidekazu Kanetaka
- Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
| | - Soichiro Shimizu
- Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
| | - Yuta Inagawa
- Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
| | - Daisuke Hirose
- Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
| | - Naoto Takenoshita
- Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
| | - Hirofumi Sakurai
- Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
| | - Haruo Hanyu
- Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
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Yu J, Du Q, Xie H, Chen J, Chen J. What and why: the current situation and future prospects of "ivy sign" in moyamoya disease. Ther Adv Chronic Dis 2020; 11:2040622320960004. [PMID: 33101620 PMCID: PMC7549182 DOI: 10.1177/2040622320960004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 08/26/2020] [Indexed: 11/17/2022] Open
Abstract
“Ivy sign” is a special imaging manifestation of moyamoya disease (MMD), which
shows continuous linear or punctate high intensity along the cortical sulci and
subarachnoid space on magnetic resonance images. Ivy sign was reported to
reflect the development of compensatory collaterals, and to be closely related
to hemodynamic changes and clinical symptoms, and to indicate the postoperative
prognosis, in MMD patients. It is a unique and critical marker for MMD. However,
due to the lack of consistent criteria, such as definition, grading, and
identification standards, ivy sign has not received much attention. We undertook
a comprehensive literature search and summarized the current situation regarding
ivy sign in MMD in terms of baseline characteristics, detection methods,
definition, regional division and distribution patterns, grading criterions,
incidence, related factors, the mechanism of ivy sign, and the effects of
treatments. We also provided related concerns raised and future prospects
relevant to studies about ivy sign in MMD.
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Affiliation(s)
- Jin Yu
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Qian Du
- Department of Rheumatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Hui Xie
- Department of Medical Image, Maternal and Child Health Hospital of Hubei Provence, Wuhan, China
| | - Jiayi Chen
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jincao Chen
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Donghu Road 169, Wuhan, 430071, China
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10
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Kaneta T. PET and SPECT imaging of the brain: a review on the current status of nuclear medicine in Japan. Jpn J Radiol 2020; 38:343-357. [DOI: 10.1007/s11604-019-00901-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 10/31/2019] [Indexed: 01/07/2023]
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11
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Ogura T. [11. Quantification Technology of SPECT Images in Brain]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2020; 76:534-542. [PMID: 32435039 DOI: 10.6009/jjrt.2020_jsrt_76.5.534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Toshiyuki Ogura
- Department of Radiology, Sapporo Azabu Neurosurgical Hospital
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12
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Ishii Y, Thamm T, Guo J, Khalighi MM, Wardak M, Holley D, Gandhi H, Park JH, Shen B, Steinberg GK, Chin FT, Zaharchuk G, Fan AP. Simultaneous phase-contrast MRI and PET for noninvasive quantification of cerebral blood flow and reactivity in healthy subjects and patients with cerebrovascular disease. J Magn Reson Imaging 2019; 51:183-194. [PMID: 31044459 DOI: 10.1002/jmri.26773] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 04/16/2019] [Accepted: 04/18/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND H2 15 O-positron emission tomography (PET) is considered the reference standard for absolute cerebral blood flow (CBF). However, this technique requires an arterial input function measured through continuous sampling of arterial blood, which is invasive and has limitations with tracer delay and dispersion. PURPOSE To demonstrate a new noninvasive method to quantify absolute CBF with a PET/MRI hybrid scanner. This blood-free approach, called PC-PET, takes the spatial CBF distribution from a static H2 15 O-PET scan, and scales it to the whole-brain average CBF value measured by simultaneous phase-contrast MRI. STUDY TYPE Observational. SUBJECTS Twelve healthy controls (HC) and 13 patients with Moyamoya disease (MM) as a model of chronic ischemic disease. FIELD STRENGTH/SEQUENCES 3T/2D cardiac-gated phase-contrast MRI and H2 15 O-PET. ASSESSMENT PC-PET CBF values from whole brain (WB), gray matter (GM), and white matter (WM) in HCs were compared with literature values since 2000. CBF and cerebrovascular reactivity (CVR), which is defined as the percent CBF change between baseline and post-acetazolamide (vasodilator) scans, were measured by PC-PET in MM patients and HCs within cortical regions corresponding to major vascular territories. Statistical Tests: Linear, mixed effects models were created to compare CBF and CVR, respectively, between patients and controls, and between different degrees of stenosis. RESULTS The mean CBF values in WB, GM, and WM in HC were 42 ± 7 ml/100 g/min, 50 ± 7 ml/100 g/min, and 23 ± 3 ml/100 g/min, respectively, which agree well with literature values. Compared with normal regions (57 ± 23%), patients showed significantly decreased CVR in areas with mild/moderate stenosis (47 ± 17%, P = 0.011) and in severe/occluded areas (40 ± 16%, P = 0.016). Data Conclusion: PC-PET identifies differences in cerebrovascular reactivity between healthy controls and cerebrovascular patients. PC-PET is suitable for CBF measurement when arterial blood sampling is not accessible, and warrants comparison to fully quantitative H2 15 O-PET in future studies. LEVEL OF EVIDENCE 3 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019. J. Magn. Reson. Imaging 2020;51:183-194.
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Affiliation(s)
- Yosuke Ishii
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Thoralf Thamm
- Department of Radiology, Stanford University, Stanford, California, USA.,Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jia Guo
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Bioengineering, University of California Riverside, Riverside, California, USA
| | | | - Mirwais Wardak
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Dawn Holley
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Harsh Gandhi
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Jun Hyung Park
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Bin Shen
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Gary K Steinberg
- Department of Neurosurgery, Stanford University, Stanford, California, USA
| | - Frederick T Chin
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Greg Zaharchuk
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Audrey Peiwen Fan
- Department of Radiology, Stanford University, Stanford, California, USA
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13
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Kanemoto H, Kazui H, Suehiro T, Kishima H, Suzuki Y, Sato S, Azuma S, Matsumoto T, Yoshiyama K, Shimosegawa E, Tanaka T, Ikeda M. Apathy and right caudate perfusion in idiopathic normal pressure hydrocephalus: A case-control study. Int J Geriatr Psychiatry 2019; 34:453-462. [PMID: 30474244 DOI: 10.1002/gps.5038] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 11/14/2018] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Apathy is prevalent in patients with idiopathic normal pressure hydrocephalus (iNPH), a treatable disorder resulting from ventricular enlargement. We assessed the relationship between apathy and regional cerebral blood flow (rCBF) in patients with iNPH. METHODS Before lumbo-peritoneal shunt surgery (LPS), 56 iNPH patients were evaluated on apathy and dysphoria subscales of the Neuropsychiatric inventory (NPI), and were divided into two groups according to NPI apathy score: 15 without apathy (iNPH-APA) and 41 with apathy (iNPH+APA). Among iNPH+APA, 29 patients were evaluated for apathy and dysphoria 3 months after LPS, and were divided into two groups on the basis of the change in NPI apathy score: 13 with improvement (iNPH+ImpAPA) and 16 without improvement in apathy (iNPH-ImpAPA). N-isopropyl-p-iodoamphetamine single photon emission computed tomography using the autoradiography method was performed before and after LPS, and rCBF was calculated in 22 regions of interest in the frontal cortex, basal ganglia, and limbic system. RESULTS In iNPH+APA, rCBF in the right caudate nuclei before LPS was significantly lower than that in iNPH-APA (P = 0.004; two-sample t test). Between iNPH-ImpAPA and iNPH+ImpAPA, a significant group-by-shunt interaction was observed for rCBF in only the right caudate nuclei (F1, 28 = 11.75, P = 0.002; two-way repeated-measures analysis of variance), with increased rCBF in iNPH+ImpAPA but not in iNPH-ImpAPA. The significant group-by-shunt interaction persisted if change in NPI dysphoria scores was used as a covariate (F1, 27 = 8.33, P = 0.008). CONCLUSIONS Our findings suggest that right caudate dysfunction might cause apathy in iNPH patients.
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Affiliation(s)
- Hideki Kanemoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan.,Department of Psychiatry, Mizuma Hospital, Kaizuka, Japan.,Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka, Japan
| | - Hiroaki Kazui
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan.,Department of Neuropsychiatry, Kochi Medical School, Kochi University, Kochi, Japan
| | - Takashi Suehiro
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Haruhiko Kishima
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yukiko Suzuki
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Shunsuke Sato
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Shingo Azuma
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Takuya Matsumoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kenji Yoshiyama
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Eku Shimosegawa
- Department of Molecular Imaging in Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Toshihisa Tanaka
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Manabu Ikeda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
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14
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Arterial spin labeling MR imaging for the clinical detection of cerebellar hypoperfusion in patients with spinocerebellar degeneration. J Neurol Sci 2018; 394:58-62. [PMID: 30216759 DOI: 10.1016/j.jns.2018.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 08/27/2018] [Accepted: 09/05/2018] [Indexed: 11/21/2022]
Abstract
PURPOSE The aim of this study was to evaluate the clinical utility of arterial spin labeling (ASL) magnetic resonance imaging (MRI) for the detection of cerebellar hypoperfusion in patients with spinocerebellar degeneration (SCD). METHODS Regional cerebral blood flow (CBF) were obtained from ASL and 123I-IMP single-photon emission computed tomography (SPECT) images by volume-of-interest analysis in patients with SCD (n = 16). Regional CBF were also measured by ASL in age-matched controls (n = 19) and by SPECT in separate controls (n = 17). The cerebellar CBF values were normalized to the CBF values for the whole gray matter (nCBF) in ASL and SPECT. RESULTS The mean cerebellar nCBF measured by ASL was lower in patients with SCD (0.70 ± 0.09) than in the controls (0.91 ± 0.05) (p < 0.001), which was consistent with the comparison using SPECT (0.82 ± 0.05 vs. 0.98 ± 0.05, p < 0.001). The cerebellar nCBF measured by ASL significantly correlated with that determined by SPECT in patients (r = 0.56, p < 0.001). CONCLUSIONS ASL imaging showed decreased cerebellar blood flow, which correlated with that measured by SPECT, in patients with SCD. These findings suggest the clinical utility of noninvasive MRI with ASL for detecting cerebellar hypoperfusion in addition to atrophy, which would aid the diagnosis of SCD.
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15
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Sato S, Kojima D, Shimada Y, Yoshida J, Fujimato K, Fujiwara S, Kobayashi M, Kubo Y, Yoshida K, Terasaki K, Tsutsui S, Miyoshi K, Ogasawara K. Preoperatively reduced cerebrovascular contractile reactivity to hypocapnia by hyperventilation is associated with cerebral hyperperfusion syndrome after arterial bypass surgery for adult patients with cerebral misery perfusion due to ischemic moyamoya disease. J Cereb Blood Flow Metab 2018; 38:1021-1031. [PMID: 29383984 PMCID: PMC5999000 DOI: 10.1177/0271678x18757621] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The present study examined whether preoperatively reduced cerebrovascular contractile reactivity to hypocapnia by hyperventilation is associated with development of cerebral hyperperfusion syndrome after arterial bypass surgery for adult patients with cerebral misery perfusion due to ischemic moyamoya disease. Among 65 adult patients with ischemic moyamoya disease, 19 had misery perfusion in the precentral region on preoperative 15O positron emission tomography and underwent arterial bypass surgery for that region. Brain technetium-99 m-labeled ethyl cysteinate dimer single-photon emission computed tomography (SPECT) was preoperatively performed with and without hyperventilation challenge and relative cerebrovascular contractile reactivity to hypocapnia (RCVCRhypocap) (%/mmHg) was calculated in the precentral region. Development of cerebral hyperperfusion syndrome was determined using perioperative changes of symptoms and brain N-isopropyl-p-[123I]-iodoamphetamine SPECT performed after surgery. RCVCRhypocap was significantly lower in the 6 patients with cerebral hyperperfusion syndrome (-2.85 ± 1.10%/mmHg) than in the 13 patients without cerebral hyperperfusion syndrome (0.18 ± 1.97%/mmHg; p = 0.0050). Multivariate analysis demonstrated low RCVCRhypocap as an independent predictor of cerebral hyperperfusion syndrome (95% confidence interval, 0.04-0.96; p = 0.0433). Preoperatively reduced cerebrovascular contractile reactivity to hypocapnia by hyperventilation is associated with development of cerebral hyperperfusion syndrome after arterial bypass surgery for adult patients with cerebral misery perfusion due to ischemic moyamoya disease.
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Affiliation(s)
- Shinpei Sato
- 1 Department of Neurosurgery, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Daigo Kojima
- 1 Department of Neurosurgery, School of Medicine, Iwate Medical University, Morioka, Japan.,2 Cyclotron Research Center, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Yasuyoshi Shimada
- 1 Department of Neurosurgery, School of Medicine, Iwate Medical University, Morioka, Japan.,2 Cyclotron Research Center, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Jun Yoshida
- 1 Department of Neurosurgery, School of Medicine, Iwate Medical University, Morioka, Japan.,2 Cyclotron Research Center, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Kentaro Fujimato
- 1 Department of Neurosurgery, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Shunrou Fujiwara
- 1 Department of Neurosurgery, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Masakazu Kobayashi
- 1 Department of Neurosurgery, School of Medicine, Iwate Medical University, Morioka, Japan.,2 Cyclotron Research Center, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Yoshitaka Kubo
- 1 Department of Neurosurgery, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Kenji Yoshida
- 1 Department of Neurosurgery, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Kazunori Terasaki
- 2 Cyclotron Research Center, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Shouta Tsutsui
- 1 Department of Neurosurgery, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Kenya Miyoshi
- 1 Department of Neurosurgery, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Kuniaki Ogasawara
- 1 Department of Neurosurgery, School of Medicine, Iwate Medical University, Morioka, Japan.,2 Cyclotron Research Center, School of Medicine, Iwate Medical University, Morioka, Japan
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16
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Ohmichi T, Kondo M, Itsukage M, Koizumi H, Matsushima S, Kuriyama N, Ishii K, Mori E, Yamada K, Mizuno T, Tokuda T. Usefulness of the convexity apparent hyperperfusion sign in 123I-iodoamphetamine brain perfusion SPECT for the diagnosis of idiopathic normal pressure hydrocephalus. J Neurosurg 2018; 130:398-405. [PMID: 29547088 DOI: 10.3171/2017.9.jns171100] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 09/25/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The gold standard for the diagnosis of idiopathic normal pressure hydrocephalus (iNPH) is the CSF removal test. For elderly patients, however, a less invasive diagnostic method is required. On MRI, high-convexity tightness was reported to be an important finding for the diagnosis of iNPH. On SPECT, patients with iNPH often show hyperperfusion of the high-convexity area. The authors tested 2 hypotheses regarding the SPECT finding: 1) it is relative hyperperfusion reflecting the increased gray matter density of the convexity, and 2) it is useful for the diagnosis of iNPH. The authors termed the SPECT finding the convexity apparent hyperperfusion (CAPPAH) sign. METHODS Two clinical studies were conducted. In study 1, SPECT was performed for 20 patients suspected of having iNPH, and regional cerebral blood flow (rCBF) of the high-convexity area was examined using quantitative analysis. Clinical differences between patients with the CAPPAH sign (CAP) and those without it (NCAP) were also compared. In study 2, the CAPPAH sign was retrospectively assessed in 30 patients with iNPH and 19 healthy controls using SPECT images and 3D stereotactic surface projection. RESULTS In study 1, rCBF of the high-convexity area of the CAP group was calculated as 35.2–43.7 ml/min/100 g, which is not higher than normal values of rCBF determined by SPECT. The NCAP group showed lower cognitive function and weaker responses to the removal of CSF than the CAP group. In study 2, the CAPPAH sign was positive only in patients with iNPH (24/30) and not in controls (sensitivity 80%, specificity 100%). The coincidence rate between tight high convexity on MRI and the CAPPAH sign was very high (28/30). CONCLUSIONS Patients with iNPH showed hyperperfusion of the high-convexity area on SPECT; however, the presence of the CAPPAH sign did not indicate real hyperperfusion of rCBF in the high-convexity area. The authors speculated that patients with iNPH without the CAPPAH sign, despite showing tight high convexity on MRI, might have comorbidities such as Alzheimer’s disease.
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Affiliation(s)
| | | | | | | | | | | | - Kazunari Ishii
- 6Molecular Pathobiology of Brain Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto
| | - Etsuro Mori
- 4Department of Radiology, Kindai University Faculty of Medicine, Osaka; and
| | | | | | - Takahiko Tokuda
- Departments of1Neurology
- 5Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan
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17
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Iizuka T, Iizuka R, Kameyama M. Cingulate island sign temporally changes in dementia with Lewy bodies. Sci Rep 2017; 7:14745. [PMID: 29116145 PMCID: PMC5677123 DOI: 10.1038/s41598-017-15263-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 10/23/2017] [Indexed: 11/09/2022] Open
Abstract
The cingulate island sign (CIS) that reflects sparing of the posterior cingulate cortex (PCC) relative to the precuneus plus cuneus on FDG-PET and brain perfusion SPECT, has been proposed as a feature of dementia with Lewy bodies (DLB). As the CIS is influenced by concomitant Alzheimer's disease (AD)-type neurofibrillary tangle (NFT) pathology, we postulated that the CIS gradually disappears as DLB progresses. To determine temporal changes in the CIS, 24 patients with mild DLB and 7 with prodromal DLB underwent 123I-IMP-SPECT and MMSE twice at an interval of two years. The CIS was evaluated as a ratio that was derived by dividing IMP accumulation in the PCC with that in the precuneus plus cuneus. We found that the CIS changed over time and that the relationship between CIS ratios and MMSE scores was inverted U-shaped. Thus, the CIS was most obvious in the vicinity of an MMSE score of 22 and it gradually diminished as the MMSE score decreased. Moreover, a lower CIS ratio in mild DLB was associated with a worse prognosis for cognitive decline, presumably due to concomitant AD-type NFT pathology. Our findings would provide a foundation for the appropriate usage of CIS as a biomarker.
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Affiliation(s)
- Tomomichi Iizuka
- Center for Dementia, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 24-1-3, Matsuyama, Kiyose-City, Tokyo, 204-8522, Japan.
| | - Rui Iizuka
- Department of Biology, Waseda University, 1-104 Totsukamachi, Shinjuku-ku, Tokyo, 169-8050, Japan
| | - Masashi Kameyama
- Division of Nuclear Medicine, Department of Radiology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.,Department of Radiology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakaecho, Itabashi-ku, Tokyo, 173-0015, Japan
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18
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The “ivy sign score” on FLAIR MR images: Clinical utility following revascularization in pediatric Moyamoya disease. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2017. [DOI: 10.1016/j.ejrnm.2017.03.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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19
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Yada N, Onishi H, Miyai M, Ozasa K, Katsube T, Onoda K, Haramoto M, Yamamoto Y, Yamaguchi S, Kitagaki H. Effect of resolution recovery using graph plots on regional cerebral blood flow in healthy volunteers. Ann Nucl Med 2017; 31:553-562. [PMID: 28664319 DOI: 10.1007/s12149-017-1186-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 06/25/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE We evaluated the effect of resolution recovery (RR) using graph plots on regional cerebral blood flow (rCBF) in brain perfusion single-photon emission computed tomography (SPECT) images derived from healthy volunteers and patients diagnosed with probable Alzheimer's disease. METHOD We acquired brain perfusion SPECT images with scatter correction (SC), computed tomography-based attenuation correction (CTAC), and RR from a three-dimensional brain phantom and from healthy volunteers. We then compared contrast-to-noise ratio, count density ratios, increase maps, and rCBF using statistical parametric mapping 8. RESULTS Regional brain counts were significantly increased from 20-24% with SC, CTAC, and RR compared with SC and CTAC. Mean CBF in healthy volunteers was 42.5 ± 5.4 mL/100 g/min. Average rCBF determined using SC, CTAC and RR increased 7.5, 2.0, and 3.7% at the thalamus, posterior cingulate, and whole brain, respectively, compared with SC and CTAC. CONCLUSION Resolution recovery caused variations in normal rCBF because counts increased in cerebral regions.
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Affiliation(s)
- Nobuhiro Yada
- Biological Systems Sciences Program, Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuen-Cho, Mihara, Hiroshima, 723-0053, Japan.
- Department of Radiology, Shimane University Hospital, 89-1 Enya-Cho, Izumo, Shimane, 693-8501, Japan.
| | - Hideo Onishi
- Biological Systems Sciences Program, Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuen-Cho, Mihara, Hiroshima, 723-0053, Japan
| | - Masahiro Miyai
- Department of Radiology, Kawasaki Medical School General Medical Center, 2-6-1, Nakayamashita, Kita-Ku, Okayama, 700-8505, Japan
| | - Kentarou Ozasa
- Department of Radiology, Shimane University Hospital, 89-1 Enya-Cho, Izumo, Shimane, 693-8501, Japan
| | - Takashi Katsube
- Department of Radiology, Shimane University Faculty of Medicine, 89-1 Enya-Cho, Izumo, Shimane, 693-8501, Japan
| | - Keiichi Onoda
- Department of Neurology, Shimane University Faculty of Medicine, 89-1 Enya-Cho, Izumo, Shimane, 693-8501, Japan
| | - Masuo Haramoto
- Department of Radiology, Shimane University Hospital, 89-1 Enya-Cho, Izumo, Shimane, 693-8501, Japan
| | - Yasushi Yamamoto
- Department of Radiology, Shimane University Hospital, 89-1 Enya-Cho, Izumo, Shimane, 693-8501, Japan
| | - Shuhei Yamaguchi
- Department of Neurology, Shimane University Faculty of Medicine, 89-1 Enya-Cho, Izumo, Shimane, 693-8501, Japan
| | - Hajime Kitagaki
- Department of Radiology, Shimane University Faculty of Medicine, 89-1 Enya-Cho, Izumo, Shimane, 693-8501, Japan
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20
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Sekine T, Takagi R, Amano Y, Murai Y, Orita E, Fukushima Y, Matsumura Y, Kumita SI. 4D Flow MR Imaging of Ophthalmic Artery Flow in Patients with Internal Carotid Artery Stenosis. Magn Reson Med Sci 2017; 17:13-20. [PMID: 28367905 PMCID: PMC5760228 DOI: 10.2463/mrms.mp.2016-0074] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background and Purpose: To assess the clinical feasibility of time-resolved 3D phase contrast (4D Flow) MRI assessment of the ophthalmic artery (OphA) flow in patients with internal carotid artery stenosis (ICS). Materials and Methods: Twenty-one consecutive patients with unilateral ICS were recruited. 4D Flow MRI and acetazolamide-stress brain perfusion single photon emission computed tomography (SPECT) were performed. The flow direction on the affected-side OphA was categorized into native flow (anterograde or unclear) and non-native flow (retrograde flow) based on 4D Flow MRI. In the affected-side middle cerebral artery (MCA) territory, the ratio of rest cerebral blood flow to normal control (RCBFMCA) and cerebral vascular reserve (CVRMCA) were calculated from SPECT dataset. High-risk patients were defined based on the previous large cohort study (RCBFMCA < 80% and CVRMCA < 10%). Results: Eleven patients had native OphA flow (4 anterograde, 7 unclear) and the remaining 10 had non-native OphA flow. RCBFMCA and CVRMCA each were significantly lower in non-native flow group (84.9 ± 18.9% vs. 69.8 ± 7.3%, P < 0.05; 36.4 ± 20.6% vs. 17.0 ± 15.0%, P < 0.05). Four patients in the non-native flow group and none in the native flow group were confirmed as high-risk (Sensitivity/Specificity, 1.00/0.65). Conclusion: The 6 min standard 4D Flow MRI assessment of OphA in patients with ICS can predict intracranial hemodynamic impairment.
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Affiliation(s)
- Tetsuro Sekine
- Department of Medical Radiology, University Hospital Zurich.,Department of Radiology, Nippon Medical School
| | - Ryo Takagi
- Department of Radiology, Nippon Medical School
| | - Yasuo Amano
- Department of Radiology, Nippon Medical School
| | - Yasuo Murai
- Department of Neurological Surgery, Nippon Medical School
| | - Erika Orita
- Department of Radiology, Nippon Medical School
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21
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Matsumoto N, Enatsu R, Matsui Y, Ikeda H, Yamana N, Oda M, Saiki M, Narumi O. Perioperative Evaluation of Cerebral Blood Flow Using (123)I-labeled N-isopropyl-p-iodoamphetamine Single-Photon Emission Computed Tomography without Blood Sampling in Patients Who Underwent Carotid Artery Stenting. Chin Med J (Engl) 2016; 129:1616-8. [PMID: 27364800 PMCID: PMC4931270 DOI: 10.4103/0366-6999.184473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Naoki Matsumoto
- Department of Neurosurgery, National Hospital Organization Himeji Medical Center, Himeji 670-8520, Hyogo, Japan
| | - Rei Enatsu
- Department of Neurosurgery, National Hospital Organization Himeji Medical Center, Himeji 670-8520, Hyogo, Japan
| | - Yasuzumi Matsui
- Department of Neurosurgery, National Hospital Organization Himeji Medical Center, Himeji 670-8520, Hyogo, Japan
| | - Hiroyuki Ikeda
- Department of Neurosurgery, National Hospital Organization Himeji Medical Center, Himeji 670-8520, Hyogo, Japan
| | - Norikazu Yamana
- Department of Neurosurgery, National Hospital Organization Himeji Medical Center, Himeji 670-8520, Hyogo, Japan
| | - Masashi Oda
- Department of Neurosurgery, National Hospital Organization Himeji Medical Center, Himeji 670-8520, Hyogo, Japan
| | - Masaaki Saiki
- Department of Neurosurgery, National Hospital Organization Himeji Medical Center, Himeji 670-8520, Hyogo, Japan
| | - Osamu Narumi
- Department of Neurosurgery, National Hospital Organization Himeji Medical Center, Himeji 670-8520, Hyogo, Japan
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22
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Iizuka T, Kameyama M. Cholinergic enhancement increases regional cerebral blood flow to the posterior cingulate cortex in mild Alzheimer's disease. Geriatr Gerontol Int 2016; 17:951-958. [PMID: 27215917 DOI: 10.1111/ggi.12818] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 03/11/2016] [Accepted: 03/31/2016] [Indexed: 10/21/2022]
Abstract
AIM The brain region that shows reductions in regional cerebral blood flow (rCBF) earliest is the posterior cingulate cortex (PCC), which is thought to have a relationship with cognitive function. We made a hypothesis that the PCC hypoperfusion is a result of cholinergic dysfunction and can be restored by cholinergic enhancement. This present longitudinal study aimed to detect the restoration of PCC rCBF in response to donepezil, an acetylcholine esterase inhibitor. METHODS We evaluated rCBF changes in the PCC, precuneus and anterior cingulate cortex using perfusion single-photon emission computed tomography (SPECT), statistical analysis and region of interest analysis, prospectively. We allocated 36 patients with mild AD to either the responder or non-responder groups based on changes in Mini-Mental State Examination scores. The patients were followed up for 18 months. RESULTS The PCC rCBF significantly increased in responders after 6 months of donepezil therapy. Statistical maps at baseline showed a typical decreased pattern of mild AD and obvious rCBF restoration in the bilateral PCC at 6 months in responders. Changes in Mini-Mental State Examination scores and the AD assessment scale cognitive scores significantly correlated with rCBF changes in the PCC of responders. CONCLUSIONS Cholinergic enhancement restored PCC rCBF under the three conditions of mild AD, responders and short follow-up interval, and that increase correlated with improved cognitive function. These findings support our hypothesis that PCC rCBF reflects cholinergic function in AD patients. Geriatr Gerontol Int 2017; 17: 951-958.
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Affiliation(s)
- Tomomichi Iizuka
- Department of Neurology, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Masashi Kameyama
- Division of Nuclear Medicine, Department of Radiology School of Medicine, Keio University, Tokyo, Japan.,Division of Nuclear Medicine, National Center for Global health and Medicine, Tokyo, Japan
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23
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Development of a simple non-invasive microsphere quantification method for cerebral blood flow using I-123-IMP. Ann Nucl Med 2016; 30:242-9. [PMID: 26733060 DOI: 10.1007/s12149-015-1053-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 12/17/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE In clinical practice, measurement of the rCBF has mainly been conducted by I-123-N-isopropyl-p-iodoamphetamine ((123)I-IMP) SPECT using the microsphere (MS) method, with continuous arterial blood sampling. While several non-invasive (123)I-IMP quantification methods have been developed, their accuracy has been shown to be lower than that of the MS method. Therefore, a non-invasive quantification method for use in routine clinical practice is being sought. The purpose of this study was to develop a simple non-invasive (123)I-IMP quantification method (SIMS method) with a simple input function-determining protocol based on the MS method. METHOD The input function for the SIMS method was determined using the administered dose and the integrated lung washout ratio obtained by analyzing the count-time activity curve of the pulmonary artery and lung on dynamic chest images. The mean CBF (mCBF) and input function measured in 80 patients by the SIMS method was compared with those determined using the MS method. RESULT A good correlation was observed between the counts measured by continuous arterial blood sampling in the MS method and the estimated counts by image analysis in the new method (r = 0.94, p < 0.01). Similarly, a good correlation was observed between the mCBF values determined by the MS method and the SIMS method (r = 0.83, p < 0.01). CONCLUSION The mCBF values determined by the SIMS method were closely consistent with the values obtained by the MS method. This finding indicates the possibility of use of the SIMS method for routine clinical study.
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24
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Yamauchi M, Imabayashi E, Matsuda H, Nakagawara J, Takahashi M, Shimosegawa E, Hatazawa J, Suzuki M, Iwanaga H, Fukuda K, Iihara K, Iida H. Quantitative assessment of rest and acetazolamide CBF using quantitative SPECT reconstruction and sequential administration of (123)I-iodoamphetamine: comparison among data acquired at three institutions. Ann Nucl Med 2014; 28:836-50. [PMID: 25001261 PMCID: PMC4244544 DOI: 10.1007/s12149-014-0879-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 06/29/2014] [Indexed: 10/27/2022]
Abstract
PURPOSE A recently developed technique which reconstructs quantitative images from original projection data acquired using existing single-photon emission computed tomography (SPECT) devices enabled quantitative assessment of cerebral blood flow (CBF) at rest and after acetazolamide challenge. This study was intended to generate a normal database and to investigate its inter-institutional consistency. METHODS The three institutions carried out a series of SPECT scanning on 32 healthy volunteers, following a recently proposed method that involved dual administration of (123)I-iodoamphetamine during a single SPECT scan. Intra-institute and inter-institutional variations of regional CBF values were evaluated both at rest and after acetazolamide challenge. Functional images were pooled for both rest and acetazolamide CBF, and inter-institutional difference was evaluated among these images using two independent software programs. RESULTS Quantitative assessment of CBF images at rest and after acetazolamide was successfully achieved with the given protocol in all institutions. Intra-institutional variation of CBF values at rest and after acetazolamide was consistent with previously reported values. Quantitative CBF values showed no significant difference among institutions in all regions, except for a posterior cerebral artery region after acetazolamide challenge in one institution which employed SPECT device with lowest spatial resolution. Pooled CBF images at rest and after acetazolamide generated using two software programs showed no institutional differences after equalization of the spatial resolution. CONCLUSIONS SPECT can provide reproducible images from projection data acquired using different SPECT devices. A common database acquired at different institutions may be shared among institutions, if images are reconstructed using a quantitative reconstruction program, and acquired by following a standardized protocol.
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Affiliation(s)
- Miho Yamauchi
- Department of Investigative Radiology, National Cerebral and Cardiovascular Center Research Institute, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565 Japan
| | - Etsuko Imabayashi
- Department of Nuclear Medicine, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298 Japan
- Present Address: Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551 Japan
| | - Hiroshi Matsuda
- Department of Nuclear Medicine, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298 Japan
- Present Address: Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551 Japan
| | - Jyoji Nakagawara
- Nakamura Memorial Hospital, 2 Kawazoe, Minami, Sapporo, Hokkaido 005-0802 Japan
- Present Address: Department of Neurosurgery, Integrative Stroke Imaging Center, National Cerebral and Cardiovascular Center Hospital, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565 Japan
| | - Masaaki Takahashi
- Nakamura Memorial Hospital, 2 Kawazoe, Minami, Sapporo, Hokkaido 005-0802 Japan
| | - Eku Shimosegawa
- Department of Nuclear Medicine, Osaka University School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Jun Hatazawa
- Department of Nuclear Medicine, Osaka University School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Michiyasu Suzuki
- Department of Neurosurgery, Yamaguchi University School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505 Japan
| | - Hideyuki Iwanaga
- Department of Radiological Technology, Yamaguchi University Hospital, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505 Japan
| | - Kenji Fukuda
- Department of Neurosurgery, National Cerebral and Cardiovascular Center Hospital, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565 Japan
- Present Address: Department of Neurosurgery, Fukuoka University School of Medicine, Fukuoka, Kyushu 814-0180 Japan
| | - Koji Iihara
- Department of Neurosurgery, National Cerebral and Cardiovascular Center Hospital, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565 Japan
- Present Address: Department of Neurosurgery, Kyushu University School of Medicine, Fukuoka, Kyushu 812-8582 Japan
| | - Hidehiro Iida
- Department of Investigative Radiology, National Cerebral and Cardiovascular Center Research Institute, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565 Japan
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Quantitative Measurement of Blood Flow Volume in the Major Intracranial Arteries by Using 123I-Iodoamphetamine SPECT. Clin Nucl Med 2014; 39:868-73. [DOI: 10.1097/rlu.0000000000000555] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Koshino K, Fukushima K, Fukumoto M, Hori Y, Moriguchi T, Zeniya T, Nishimura Y, Kiso K, Iida H. Quantification of myocardial blood flow using (201)Tl SPECT and population-based input function. Ann Nucl Med 2014; 28:917-25. [PMID: 25049112 DOI: 10.1007/s12149-014-0888-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Accepted: 07/12/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Thallium-201 ((201)Tl) single photon emission computed tomography (SPECT) is an important tool in the diagnosis of ischemic heart disease. Absolute quantification of myocardial blood flow (MBF) has the potential to provide more useful information on myocardial perfusion than semi-quantitative assessments. This study aimed to validate the quantification of MBF using (201)Tl cardiac SPECT based on a population-averaged input function (STD-IF) and one-point blood sample technique. METHODS (201)Tl emission and computed tomography (CT)-based attenuation scans were performed on 11 healthy volunteers at rest using a SPECT/CT scanner. Individual input functions (IND-IFs) during the emission scans were based on arterial blood samples. The STD-IF technique was validated as follows: (1) optimal time to calibrate a STD-IF was determined to minimize differences between the calibrated STD-IF and the IND-IFs. (2) Tissue time-activity curves (TTACs) were generated based on a single-tissue compartment model for MBFtrue = 0.5, 1.0, 1.5, and 2.0 mL/min/g, a constant distribution volume of 45 mL/mL, and IND-IFs. The pseudo STD-IF for each subject was generated using the leave-one-out technique. Using the optimal calibration time and the pseudo STD-IFs, MBF values were estimated on the TTACs with an autoradiography method. Optimal mid-scan time (MST) with a fixed duration of 20 min was determined to minimize intersubject variation in estimated MBF errors, and (3) Global and regional MBF values estimated with pseudo STD-IFs were compared to those with IND-IFs using the optimal calibration time and MST. RESULTS The optimal calibration time and MST were both 20 min after (201)Tl injection. Global MBF determined using both IND-IFs and pseudo STD-IF showed significant correlations with rate-pressure products, R (2) = 0.645; p < 0.01 and R (2) = 0.303; p < 0.05, respectively. The mean percent error in regional MBF using pseudo STD-IFs was 0.69 ± 7.80 % (-12.80 to 14.25 %). No significant difference was observed between regional MBF values using IND-IFs and pseudo STD-IFs. CONCLUSION This study demonstrated that the proposed technique based on a STD-IF and one-point blood sample provided hemodynamically reasonable global MBF values and the regional MBF values comparable to those with IND-IFs.
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Affiliation(s)
- Kazuhiro Koshino
- Department of Investigative Radiology, National Cerebral and Cardiovascular Center Research Institute, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan,
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IWANAGA T, HARADA M, KUBO H, FUNAKOSHI Y, KUNIKANE Y, MATSUDA T. Operator-bias-free Comparison of Quantitative Perfusion Maps Acquired with Pulsed-continuous Arterial Spin Labeling and Single-photon-emission Computed Tomography. Magn Reson Med Sci 2014; 13:239-49. [DOI: 10.2463/mrms.2013-0117] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Takashi IWANAGA
- Department of Medical Imaging, Institute of Health Biosciences, The University of Tokushima Graduate School
| | - Masafumi HARADA
- Department of Radiology, Institute of Health Biosciences, The University of Tokushima Graduate School
| | - Hitoshi KUBO
- Department of Radiology, Institute of Health Biosciences, The University of Tokushima Graduate School
| | - Yasuhiro FUNAKOSHI
- Department of Medical Imaging, Institute of Health Biosciences, The University of Tokushima Graduate School
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Brain regions associated with cognitive impairment in patients with Parkinson disease: quantitative analysis of cerebral blood flow using 123I iodoamphetamine SPECT. Clin Nucl Med 2013; 38:315-20. [PMID: 23478846 DOI: 10.1097/rlu.0b013e3182873511] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE Cognitive impairment is a representative neuropsychiatric presentation that accompanies Parkinson disease (PD). The purpose of this study was to localize the cerebral regions associated with cognitive impairment in patients with PD using quantitative SPECT. PATIENTS AND METHODS Thirty-two patients with PD (mean [SD] age, 75 [8] years; 25 women; Hoehn-Yahr scores from 2 to 5) underwent quantitative brain SPECT using 123I iodoamphetamine. Parametric images of regional cerebral blood flow (rCBF) were spatially normalized to the standard brain atlas. First, voxel-by-voxel comparison between patients with PD with versus without cognitive impairment was performed to visualize overall trend of regional differences. Next, the individual quantitative rCBF values were extracted in representative cortical regions using a standard region-of-interest template to compare the quantitative rCBF values. RESULTS Patients with cognitive impairment showed trends of lower rCBF in the left frontal and temporal cortices as well as in the bilateral medial frontal and anterior cingulate cortices in the voxel-by-voxel analyses. Region-of-interest-based analysis demonstrated significantly lower rCBF in the bilateral anterior cingulate cortices (right, 25.8 [5.5] vs 28.9 [5.7] mL per 100 g/min, P < 0.05; left, 25.8 [5.8] vs 29.1 [5.7] mL per 100 g/min, P < 0.05) associated with cognitive impairment. CONCLUSIONS Patients with cognitive impairment showed lower rCBF in the left frontal and temporal cortices as well as in the bilateral medial frontal and anterior cingulate cortices. The results suggested dysexecutive function as an underlining mechanism of cognitive impairment in patients with PD.
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Shimosegawa E, Fujino K, Kato H, Hatazawa J. Quantitative CBF measurement using an integrated SPECT/CT system: validation of three-dimensional ordered-subset expectation maximization and CT-based attenuation correction by comparing with O-15 water PET. Ann Nucl Med 2013; 27:822-33. [PMID: 23824783 DOI: 10.1007/s12149-013-0752-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Accepted: 06/20/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Eku Shimosegawa
- Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan,
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Reproducibility of cerebral blood flow assessment using a quantitative SPECT reconstruction program and split-dose 123I-iodoamphetamine in institutions with different γ-cameras and collimators. J Cereb Blood Flow Metab 2012; 32:1757-64. [PMID: 22617648 PMCID: PMC3434636 DOI: 10.1038/jcbfm.2012.67] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Single photon emission computed tomography (SPECT) is used widely in clinical studies. However, the technique requires image reconstruction and the methods for correcting scattered radiation and absorption are not standardized among SPECT procedures. Therefore, quantitation of cerebral blood flow (CBF) may not be constant across SPECT models. The quantitative SPECT (QSPECT) software package has been developed for standardization of CBF. Using the QSPECT/dual-table autoradiographic (DTARG) method, CBF and cerebral vascular reactivity (CVR) at rest and after acetazolamide challenge can be evaluated using (123)I-iodoamphetamine in a single SPECT session. In this study, we examined the reproducibility of quantitative regional CBF and CVR in QSPECT/DTARG using different SPECT models at two facilities. The subjects were nine patients with chronic cerebral ischemic disease who underwent QSPECT/DTARG at both facilities with use of different γ-cameras and collimators. There were significant correlations for CBF at rest and after acetazolamide challenge measured at the two facilities. The consistency of the CBFs of the patients measured at the two facilities were good in all cases. Our results show that CBF measured by QSPECT/DTARG in the same patients is reproducible in different SPECT models. This indicates that standardized evaluation of CBF can be performed in large multicenter studies.
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Estimation of 123I-IMP Arterial Blood Activity Using 123I-IMP Acquisition Data From the Lungs and Brain Without Any Blood Sampling. Clin Nucl Med 2012; 37:258-63. [DOI: 10.1097/rlu.0b013e31823928a7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ito S, Takaki A, Inoue S, Tomiguchi S, Shiraishi S, Akiyama Y, Sasaki T, Odajima S, Teraoka S, Hosoya T, Soma T, Miyazaki Y, Kinuya S, Yamashita Y. Improvement of the 99mTc-ECD brain uptake ratio (BUR) method for measurement of cerebral blood flow. Ann Nucl Med 2012; 26:351-8. [DOI: 10.1007/s12149-012-0582-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Accepted: 01/27/2012] [Indexed: 10/28/2022]
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Uchihashi Y, Hosoda K, Zimine I, Fujita A, Fujii M, Sugimura K, Kohmura E. Clinical application of arterial spin-labeling MR imaging in patients with carotid stenosis: quantitative comparative study with single-photon emission CT. AJNR Am J Neuroradiol 2011; 32:1545-51. [PMID: 21757531 DOI: 10.3174/ajnr.a2525] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Arterial spin-labeling is an emerging technique for noninvasive measurement of cerebral perfusion, but concerns remain regarding the reliability of CBF quantification and clinical applications. Recently, an ASL implementation called QUASAR was proposed, and it was shown to have good reproducibility of CBF assessment in healthy volunteers. This study aimed to determine the utility of QUASAR for CBF assessment in patients with cerebrovascular diseases. MATERIALS AND METHODS Twenty patients with carotid stenosis underwent CBF quantification by ASL (QUASAR) within 3 days of performance of (123)I-iodoamphetamine-SPECT. CVR to acetazolamide also was assessed by ASL and SPECT. In surgically treated patients, the respective scans before and after the procedures were compared. RESULTS Regional CBF and CVR values measured by ASL were significantly correlated and agreed with those measured by SPECT (r(s) = 0.92 and 0.88, respectively). A Bland-Altman plot demonstrated good agreement between 2 methods in terms of CBF quantification. Furthermore, ASL could detect pathologic states such as hypoperfusion, impaired vasoreactivity, and postoperative hyperperfusion, equivalent to SPECT. However, ASL tended to overestimate CBF values especially in high-perfusion regions. CONCLUSIONS ASL perfusion MR imaging is clinically applicable and can be an alternative method for CBF assessment in patients with cerebrovascular diseases.
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Affiliation(s)
- Y Uchihashi
- Department of Neurosurgery, Kobe University Graduate School of Medicine, Japan
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Zeniya T, Watabe H, Hayashi T, Ose T, Myojin K, Taguchi A, Yamamoto A, Teramoto N, Kanagawa M, Yamamichi Y, Iida H. Three-dimensional quantitation of regional cerebral blood flow in mice using a high-resolution pinhole SPECT system and 123I-iodoamphetamine. Nucl Med Biol 2011; 38:1157-64. [PMID: 21741253 DOI: 10.1016/j.nucmedbio.2011.04.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Revised: 03/28/2011] [Accepted: 04/23/2011] [Indexed: 11/29/2022]
Abstract
INTRODUCTION This study is intended to evaluate the feasibility of using a high-resolution pinhole SPECT system and iodine-123-N-isopropyl-4-iodoamphetamine ((123)I-IMP) for three-dimensional (3D) absolute quantitation of regional cerebral blood flow (rCBF) in mice. METHODS The pinhole SPECT system consists of a rotating stage and a pinhole collimator attached to a clinical gamma camera. The collimator's focal length is 251 mm. Phantom studies were performed to evaluate sensitivity and full-width half-maximum (FWHM) spatial resolution. The aperture-to-object distance was 15 mm. Six mice were studied. Cerebral infarctions were induced by ligating and disconnecting the distal portion of the left middle cerebral artery. Ex vivo SPECT studies were performed using harvested brains and skulls. The CBF volumetric image was computed using the standardized input function. RESULTS Excellent spatial resolution of 0.9-mm FWHM and uniform sensitivity throughout the 3D volume were demonstrated in the phantom experiments. The CBF images showed a defect in the infarcted areas and a reduction of CBF values in the infarcted region as compared with the control region. CONCLUSIONS This study demonstrated the feasibility of the 3D quantitation of rCBF in mice using a high-resolution pinhole SPECT system and (123)I-IMP.
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Affiliation(s)
- Tsutomu Zeniya
- Department of Investigative Radiology, National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka, Japan.
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Iida H, Nakagawara J, Hayashida K, Fukushima K, Watabe H, Koshino K, Zeniya T, Eberl S. Multicenter evaluation of a standardized protocol for rest and acetazolamide cerebral blood flow assessment using a quantitative SPECT reconstruction program and split-dose 123I-iodoamphetamine. J Nucl Med 2010; 51:1624-31. [PMID: 20847163 DOI: 10.2967/jnumed.110.078352] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED SPECT can provide valuable diagnostic and treatment response information in large-scale multicenter clinical trials. However, SPECT has been limited in providing consistent quantitative functional parametric values across the centers, largely because of a lack of standardized procedures to correct for attenuation and scatter. Recently, a novel software package has been developed to reconstruct quantitative SPECT images and assess cerebral blood flow (CBF) at rest and after acetazolamide challenge from a single SPECT session. This study was aimed at validating this technique at different institutions with a variety of SPECT devices and imaging protocols. METHODS Twelve participating institutions obtained a series of SPECT scans on physical phantoms and clinical patients. The phantom experiments included the assessment of septal penetration for each collimator used and of the accuracy of the reconstructed images. Clinical studies were divided into 3 protocols, including intrainstitutional reproducibility, a comparison with PET, and rest-rest study consistency. The results from 46 successful studies were analyzed. RESULTS Activity concentration estimation (Bq/mL) in the reconstructed SPECT images of a uniform cylindric phantom showed an interinstitution variation of ±5.1%, with a systematic underestimation of concentration by 12.5%. CBF values were reproducible both at rest and after acetazolamide on the basis of repeated studies in the same patient (mean ± SD difference, -0.4 ± 5.2 mL/min/100 g, n = 44). CBF values were also consistent with those determined using PET (-6.1 ± 5.1 mL/min/100 g, n = 6). CONCLUSION This study demonstrates that SPECT can quantitatively provide physiologic functional images of rest and acetazolamide challenge CBF, using a quantitative reconstruction software package.
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Affiliation(s)
- Hidehiro Iida
- Dual-Table Autoradiography SPECT Research Group in Japan, Osaka, Japan.
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Measurement of cerebral blood flow by the autoradiographic method with N-isopropyl-4-[I-123] iodoamphetamine: comparison of radiopharmaceuticals marketed by different companies in Japan. Ann Nucl Med 2009; 23:355-61. [DOI: 10.1007/s12149-009-0242-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2008] [Accepted: 01/08/2009] [Indexed: 11/26/2022]
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Mori N, Mugikura S, Higano S, Kaneta T, Fujimura M, Umetsu A, Murata T, Takahashi S. The leptomeningeal "ivy sign" on fluid-attenuated inversion recovery MR imaging in Moyamoya disease: a sign of decreased cerebral vascular reserve? AJNR Am J Neuroradiol 2009; 30:930-5. [PMID: 19246527 DOI: 10.3174/ajnr.a1504] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Moyamoya disease is an idiopathic occlusive cerebrovascular disorder with abnormal microvascular proliferation. We investigated the clinical utility of leptomeningeal high signal intensity (ivy sign) sometimes seen on fluid-attenuated inversion recovery images in Moyamoya disease. MATERIALS AND METHODS We examined the relationship between the degree of the ivy sign and the severity of the ischemic symptoms in 96 hemispheres of 48 patients with Moyamoya disease. We classified each cerebral hemisphere into 4 regions from anterior to posterior. In 192 regions of 24 patients, we examined the relationship between the degree of the ivy sign and findings of single-photon emission CT, including the resting cerebral blood flow (CBF) and cerebral vascular reserve (CVR). RESULTS The degree of the ivy sign showed a significant positive relationship with the severity of the ischemic symptoms (P < .001). Of the 4 regions, the ivy sign was most frequently and prominently seen in the anterior part of the middle cerebral artery region. The degree of the ivy sign showed a negative relationship with the resting CBF (P < .0034) and a more prominent negative relationship with the CVR (P < .001). CONCLUSIONS The leptomeningeal ivy sign indicates decreased CVR in Moyamoya disease.
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Affiliation(s)
- N Mori
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan.
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Murayama K, Katada K, Nakane M, Toyama H, Anno H, Hayakawa M, Ruiz DSM, Murphy KJ. Whole-Brain Perfusion CT Performed with a Prototype 256–Detector Row CT System: Initial Experience. Radiology 2009; 250:202-11. [PMID: 19092094 DOI: 10.1148/radiol.2501071809] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Kazuhiro Murayama
- Department of Radiology, Faculty of Radiological Technology, School of Health Sciences, Fujita Health University, Toyoake, Aichi 470-1192, Japan.
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Nagaki A. [Nuclear neuroimaging]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2008; 64:1426-1438. [PMID: 19060437 DOI: 10.6009/jjrt.64.1426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Kawamura Y, Ashizaki M, Saida S, Sugimoto H. Usefulness of rate of increase in SPECT counts in one-day method of N-isopropyl-4-iodoamphetamine [123I] SPECT studies at rest and after acetazolamide challenge using a method for estimating time-dependent distribution at rest. Ann Nucl Med 2008; 22:457-63. [PMID: 18600426 DOI: 10.1007/s12149-008-0134-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2007] [Accepted: 02/06/2008] [Indexed: 11/29/2022]
Abstract
OBJECTIVE When N-isopropyl-4-iodoamphetamine ((123)I-IMP) single-photon emission computed tomography (SPECT) studies at rest and after acetazolamide (ACZ) challenge are conducted in a day, the time-dependent change in IMP in the brain at rest should be estimated accurately. We devised the method and investigated whether our one-day method for measuring the rate of increase in SPECT counts allowed reduction in the acquisition time. METHODS Sequential, 5-min SPECT scans were performed. We estimated the time-dependent change in the brain using the change in slopes of two linear equations derived from the first three SPECT counts. For the one-day method, ACZ was administered 15 min or 20 min after IMP administration. The second IMP was administered 10 min after ACZ administration. RESULTS Time-dependent changes in the brain were classified into 13 patterns when estimation was started at 5 min after IMP administration and 6 patterns when estimation was started at 10 min, and fitting coefficients were determined. The correlation between actual measurements at 37.5 min and estimates was high with a correlation coefficient of 0.99 or greater. Rates of increase obtained from 20-min data were highly correlated with those obtained from 15-min or 10-min data (r = 0.97 or greater). In patients with unilateral cerebrovascular disease, the rate of increase on the unaffected side was 44.4 +/- 10.9% when ACZ was administered 15 min later and 48.0 +/- 16.0% when ACZ was administered 20 min later, and the rates of increase with different timings of administration were not significantly different. CONCLUSIONS The examination time may be reduced from 50 min to 45 min or 40 min as needed. The rate of increase was not influenced by the time frame for determination or the timing of ACZ administration. These findings suggest that our estimation method is accurate and versatile.
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Affiliation(s)
- Yoshifumi Kawamura
- Department of Radiology, Jichi Medical University Hospital, 311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan.
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Yoshida A, Shishido F, Kato K, Watanabe H, Seino O. Evaluation of cerebral perfusion in patients with neuropsychiatric systemic lupus erythematosus using 123I-IMP SPECT. Ann Nucl Med 2007; 21:151-8. [PMID: 17561586 DOI: 10.1007/s12149-006-0006-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE In the course of systemic lupus erythematosus (SLE), central nervous system (CNS) complications occur at a high frequency. An accurate diagnosis of CNS lupus, differentiated from secondary CNS involvement, is difficult. CNS lupus is indicative of advancing primary disease and is treated by steroid pulse therapy or increased dosage of steroids. In contrast, if symptoms are caused by secondary CNS complications, it is possible to observe or treat these complications using symptomatic therapy. We examined whether quantitative cerebral blood flow (CBF) measured using cerebral perfusion single photon emission computed tomography (SPECT) can be used to differentiate CNS lupus from secondary CNS involvement. METHODS We divided 18 SLE patients with CNS symptoms into a CNS lupus group and a non-CNS lupus group, and then compared the mean cerebral blood flow (mCBF) of each group of patients. SPECT was performed with N-isopropyl-p-[123I] iodoamphetamine (IMP), with quantitation carried out by table look-up and autoradiographic methods. RESULTS The mCBF of both groups was decreased; however, the mCBF of patients with CNS lupus was significantly lower than that of non-CNS lupus patients. CONCLUSION Quantitative CBF may provide a useful tool to distinguish CNS lupus from non-CNS lupus.
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Affiliation(s)
- Atsuko Yoshida
- Department of Radiology, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima-city, Fukushima 960-1295, Japan.
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Nakagawara J. Cerebral Ischemia and Single Photon Emission Computed Tomography( Recent Advances in SPECT and PET in the Diagnosis of Cerebral Ischemia). ACTA ACUST UNITED AC 2007. [DOI: 10.7887/jcns.16.753] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jyoji Nakagawara
- Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital
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Mimura H, Sone T, Takahashi Y, Yoshioka K, Murase K, Matsuda H, Tomomitsu T, Fukunaga M. Measurement of regional cerebral blood flow with123I-IMP using one-point venous blood sampling and causality analysis: Evaluation by comparison with conventional continuous arterial blood sampling. Ann Nucl Med 2006; 20:589-95. [PMID: 17294669 DOI: 10.1007/bf02984656] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Arterial input function represents the delivery of intravascular tracer to the brain. The optimal setting of this function is essential for measuring regional cerebral blood flow (rCBF) based on the microsphere model using N-isopropyl-4-[123I]iodoamphetamine (123I-IMP), in which the arterial 123I-IMP concentration (integral value) during the initial 5 min is usually applied. We developed a novel method in which the arterial 123I-IMP concentration is estimated from that in venous blood samples. METHODS Brain perfusion SPECT with 123I-IMP was performed in 110 patients with disorders of the central nervous system. A causality analysis determined the relationship between various SPECT parameters and the ratio of the octanol-extracted arterial radioactivity concentration during the first 5 min (Caoct) to the octanol-extracted venous radioactivity concentration at 27 min after an intravenous injection of 123I-IMP (Cvoct). The Caoct/Cvoct value was estimated using various SPECT parameters and compared with the directly measured value. RESULTS The measured and estimated values of Caoct/ Cvoct (r = 0.856, n = 50) closely correlated when the following 7 parameters were included in the regression formula: radioactivity concentration in venous blood sampled at 27 min (Cv), Cvoct, Cvoct/Cv, and 4 parameters related to cerebral tissue accumulation that were measured using a four-head gamma camera 5 and 28 min after 123I-IMP injection. Furthermore, the rCBF values obtained using the input function estimated by this method also closely correlated with the rCBF values measured using the continuous arterial blood sampling (r = 0.912, n = 180). CONCLUSION These results suggest that this method would serve as a convenient and less invasive method of rCBF measurement in the clinical setting.
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Affiliation(s)
- Hiroaki Mimura
- Department of Nuclear Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan.
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Kim KM, Watabe H, Hayashi T, Hayashida K, Katafuchi T, Enomoto N, Ogura T, Shidahara M, Takikawa S, Eberl S, Nakazawa M, Iida H. Quantitative mapping of basal and vasareactive cerebral blood flow using split-dose 123I-iodoamphetamine and single photon emission computed tomography. Neuroimage 2006; 33:1126-35. [PMID: 17035048 DOI: 10.1016/j.neuroimage.2006.06.064] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2005] [Revised: 03/01/2006] [Accepted: 06/25/2006] [Indexed: 11/19/2022] Open
Abstract
A new method has been developed for diffusible tracers, to quantify CBF at rest and after pharmacological stress from a single session of dynamic scans with dual bolus administration of a radiotracer. The calculation process consisted of three steps, including the procedures of incorporating background radioactivity contaminated from the previous scan. Feasibility of this approach was tested on clinical SPECT studies on 16 subjects. Two sequential SPECT scans, 30 min apart, were carried out on each subject, after each of two split-dose administrations of 111 MBq IMP. Of these, 11 subjects received acetazolamide at 10 min before the second IMP injection. Additional PET scans were also carried out on 6 subjects on a separate day, at rest and after acetazolamide administration. The other 5 subjects were scanned only at rest during the whole study period. Quantitative CBF obtained by this method was in a good agreement with those determined with PET (y(ml/100 g/min)=1.07x(ml/100 g/min)-1.14, r=0.94). Vasareactivity was approximately 40% over the whole cerebral area on healthy controls, which was consistent with a literature value. Reproducibility of CBF determined in the rest-rest study was 1.5+/-5.7%. Noise enhancement of CBF images, particularly the second CBF, was reduced, providing reasonable image quality. Repeat assessment of quantitative CBF from a single session of scans with split-dose IMP is accurate, and may be applied to clinical research for assessing vascular reactivity in patients with chronic cerebral vascular disease.
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Affiliation(s)
- Kyeong Min Kim
- Department of Investigative Radiology, National Cardiovascular Center Research Institute, 5-7-1 Fujishiro-dai, Suita City, Osaka, 565-8565, Japan
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Ito H, Sato T, Odagiri H, Inoue K, Shidahara M, Suhara T, Hatazawa J, Fukuda H. Brain and whole body distribution ofN-isopropyl-4-iodoamphetamine (I-123) in humans: Comparison of radiopharmaceuticals marketed by different companies in Japan. Ann Nucl Med 2006; 20:493-8. [PMID: 17037282 DOI: 10.1007/bf02987259] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Iodine-123 (123I)-labeled N-isopropyl-4-iodoamphetamine (IMP) has been used as a cerebral blood flow (CBF) tracer for single-photon emission computed tomography (SPECT). An autoradiographic (ARG) method has been developed for the quantitation of CBF by IMP and SPECT. Two IMPs (IMPA and IMPB) produced by different radiopharmaceutical companies are marketed in Japan. In the present study, whole-body distributions including brain and blood of the two IMPs were compared in the same human subjects. METHODS Two brain SPECT studies using IMPA or IMPB were performed on separate days in six young healthy men. Whole-body scans were also obtained with a large field-of-view single-head gamma camera. One-point arterial blood sampling was performed at 10 min after injection of IMP to measure both the radioactivity concentrations of whole blood and of octanol-extracted components. RESULTS No significant differences between the two tracers were observed in body distribution, tracer kinetics in brain, or regional distribution in brain. However, the octanol extraction fraction in blood was significantly different between the two tracers. Radiochemical purity was slightly but significantly different between the tracers. CONCLUSIONS In the ARG method, arterial input function is determined by calibration of a standard input function with the radioactivity concentration of arterial whole blood. Because the standard input function in the ARG method was obtained using IMPA, the standard input function obtained for IMPB should be used when CBF is calculated by the ARG method with IMPB.
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Affiliation(s)
- Hiroshi Ito
- Department of Nuclear Medicine and Radiology, Division of Brain Sciences, Institute of Development, Aging and Cancer, Tohoku University.
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Ito H, Inoue K, Goto R, Kinomura S, Taki Y, Okada K, Sato K, Sato T, Kanno I, Fukuda H. Database of normal human cerebral blood flow measured by SPECT: I. Comparison between I-123-IMP, Tc-99m-HMPAO, and Tc-99m-ECD as referred with O-15 labeled water PET and voxel-based morphometry. Ann Nucl Med 2006; 20:131-8. [PMID: 16615422 DOI: 10.1007/bf02985625] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Three accumulative tracers, iodine-123-labeled N-isopropyl-p-iodoamphetamine (I-123-IMP), technetium-99m-labeled hexamethylpropyleneamineoxime (Tc-99m-HMPAO), and technetium-99m-labeled ethyl cysteinate dimer (Tc-99m-ECD) are widely used to measure cerebral blood flow (CBF) in single-photon emission computed tomography (SPECT). In the present study, normal regional distribution of CBF measured with three different SPECT tracers was entered into a database and compared with regional distribution of CBF measured by positron emission tomography (PET) with H2(15)O. The regional distribution of tissue fractions of gray matter determined by voxel-based morphometry was also compared with SPECT and PET CBF distributions. METHODS SPECT studies with I-123-IMP, Tc-99m-HMPAO, and Tc-99m-ECD were performed on 11, 20, and 17 healthy subjects, respectively. PET studies were performed on 11 healthy subjects. Magnetic resonance (MR) imaging studies for voxel-based morphometry were performed on 43 of the 48 subjects who underwent SPECT study. All SPECT, PET, and MR images were transformed into the standard brain format with the SPM2 system. The voxel values of each SPECT and PET image were globally normalized to 50 ml/100 ml/min. Gray matter, white matter, and cerebrospinal fluid images were segmented and extracted from all transformed MR images by applying voxel-based morphometry methods with the SPM2 system. RESULTS Regional distribution of all three SPECT tracers differed from that of H2150 in the pons, midbrain, thalamus, putamen, parahippocampal gyrus, posterior cingulate gyrus, temporal cortex, and occipital cortex. No significant correlations were observed between the tissue fraction of gray matter and CBF with any tracer. CONCLUSION Differences in regional distribution of SPECT tracers were considered to be caused mainly by differences in the mechanism of retention of tracers in the brain. Regional distribution of CBF was independent of regional distribution of gray matter fractions, and consequently the blood flow per gray matter volume differed for each brain region.
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Affiliation(s)
- Hiroshi Ito
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
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Narumoto J, Ueda H, Tsuchida H, Yamashita T, Kitabayashi Y, Fukui K. Regional cerebral blood flow changes in a patient with delusional parasitosis before and after successful treatment with risperidone: a case report. Prog Neuropsychopharmacol Biol Psychiatry 2006; 30:737-40. [PMID: 16431007 DOI: 10.1016/j.pnpbp.2005.11.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/30/2005] [Indexed: 12/13/2022]
Abstract
The pathophysiology and appropriate pharmacological interventions for delusional parasitosis (DP) remain unknown. Here, we present a case of DP following brain infarction of the right temporoparietal region. Pharmacotherapy with risperidone resulted in a dramatic therapeutic response over a short period. In a sequential N-isopropyl-p-[(123)I]-iodoamphetamine single photon emission computed tomography ([(123)I]-IMP SPECT) study, post-treatment SPECT images revealed a marked increase of rCBF in the large areas including the bilateral frontal and left temporoparietal regions, the right parietal operculum and the bilateral basal ganglia, in contrast to pre-treatment SPECT images showing a global decrease of rCBF. Our clinical outcome suggests the efficacy and safety of risperidone for treatment of DP and that both dopaminergic and serotonergic dysfunction may play a role in DP. Our sequential SPECT findings suggest that psychiatric improvement of DP is associated with increased rCBF.
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Affiliation(s)
- Jin Narumoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
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Inoue K, Ito H, Shidahara M, Goto R, Kinomura S, Sato K, Taki Y, Okada K, Kaneta T, Fukuda H. Database of normal human cerebral blood flow measured by SPECT: II. Quantification of I-123-IMP studies with ARG method and effects of partial volume correction. Ann Nucl Med 2006; 20:139-46. [PMID: 16615423 DOI: 10.1007/bf02985626] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
UNLABELLED The limited spatial resolution of SPECT causes a partial volume effect (PVE) and can lead to the significant underestimation of regional tracer concentration in the small structures surrounded by a low tracer concentration, such as the cortical gray matter of an atrophied brain. The aim of the present study was to determine, using 123I-IMP and SPECT, normal CBF of elderly subjects with and without PVE correction (PVC), and to determine regional differences in the effect of PVC and their association with the regional tissue fraction of the brain. METHODS Quantitative CBF SPECT using 123I-IMP was performed in 33 healthy elderly subjects (18 males, 15 females, 54-74 years old) using the autoradiographic method. We corrected CBF for PVE using segmented MR images, and analyzed quantitative CBF and regional differences in the effect of PVC using tissue fractions of gray matter (GM) and white matter (WM) in regions of interest (ROIs) placed on the cortical and subcortical GM regions and deep WM regions. RESULTS The mean CBF in GM-ROIs were 31.7 +/- 6.6 and 41.0 +/- 8.1 ml/100 g/min for males and females, and in WM-ROIs, 18.2 +/- 0.7 and 22.9 +/- 0.8 ml/100 g/min for males and females, respectively. The mean CBF in GM-ROIs after PVC were 50.9 +/- 12.8 and 65.8 +/- 16.1 ml/100 g/min for males and females, respectively. There were statistically significant differences in the effect of PVC among ROIs, but not between genders. The effect of PVC was small in the cerebellum and parahippocampal gyrus, and it was large in the superior frontal gyrus, superior parietal lobule and precentral gyrus. CONCLUSION Quantitative CBF in GM recovered significantly, but did not reach values as high as those obtained by invasive methods or in the H2(15)O PET study that used PVC. There were significant regional differences in the effect of PVC, which were considered to result from regional differences in GM tissue fraction, which is more reduced in the frontoparietal regions in the atrophied brain of the elderly.
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Affiliation(s)
- Kentaro Inoue
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.
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Miyazawa N, Arbab AS, Umeda T, Akiyama I. Perfusion CT investigation of chronic internal carotid artery occlusion: comparison with SPECT. Clin Neurol Neurosurg 2005; 108:11-7. [PMID: 16098657 DOI: 10.1016/j.clineuro.2004.12.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2003] [Revised: 12/10/2004] [Accepted: 12/15/2004] [Indexed: 11/19/2022]
Abstract
This study investigated the usefulness of perfusion computed tomography (CT) for the evaluation of patients with chronic internal carotid artery (ICA) occlusion by comparing the findings with those of iodine-123 iodoamphetamine ([(123)I]IMP) single photon emission computed tomography (SPECT). Twenty five patients with chronic ICA occlusion were investigated on the same day by perfusion CT to measure the cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transient time (MTT), and [(123)I]IMP SPECT to measure the regional CBF, significant correlations were observed between regional CBF measured by SPECT and CBF measured by perfusion CT (r = 0.659, R(2) = 0.434, p < 0.001), regional CBF and CBV (r = -0.406, R(2) = 0.165, p < 0.001) and regional CBF and MTT (r = -0.592, R(2) = 0.350, p < 0.001). Significant correlations were also observed between CBF and CBV (r = -0.153, R(2) = 0.023, p < 0.001), CBF and MTT (r = -0.580, R(2) = 0.337, p < 0.001) and MTT and CBV (r = 0.763, R(2) = 0.582, p < 0.001). Perfusion CT is useful to evaluate the hemodynamic state of patients with chronic major cerebral artery occlusive disorders.
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Affiliation(s)
- Nobuhiko Miyazawa
- Department of Neurosurgery, Akiyama Neurosurgical Clinic, Nirasaki, Yamanashi, Japan.
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