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Ikeuchi Y, Kohta M, Yamashita S, Yamanishi S, Yamaguchi Y, Tanaka J, Tanaka K, Kimura H, Fujita A, Hosoda K, Kohmura E, Sasayama T. Predicting impaired cerebrovascular reactivity and risk of hyperperfusion syndrome in carotid artery stenosis using BeamSAT magnetic resonance imaging. J Neurol Sci 2024; 463:123114. [PMID: 39033734 DOI: 10.1016/j.jns.2024.123114] [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: 04/08/2024] [Revised: 06/02/2024] [Accepted: 06/24/2024] [Indexed: 07/23/2024]
Abstract
Pencil-beam presaturation (BeamSAT) magnetic resonance imaging (MRI) produces selective magnetic resonance angiography (MRA) images of specific arteries, including the unilateral internal carotid artery (ICA-selective MRA) or vertebral artery (VA-selective MRA). We evaluate the influence of flow pattern, visualized using BeamSAT MRI, on preoperative cerebral hemodynamic status and postoperative hyperperfusion syndrome (HPS). Patients undergoing carotid artery stenting or carotid endarterectomy were categorized into two groups to evaluate flow pattern. Patients with neither crossflow on BeamSAT MRI nor mismatch in middle cerebral artery (MCA) signal intensity between ICA-selective and conventional MRA were classified into Group I, comprising 29 patients. Group II included all other patients comprising 19 patients, who were suspected of experiencing changes in intracranial flow patterns. Cerebral blood flow and cerebrovascular reactivity (CVR) were assessed using single-photon emission computed tomography, and potential HPS symptoms were retrospectively assessed by chart review. Preoperative ipsilateral CVR was significantly lower in Group II than in Group I (18.0% ± 20.0% vs. 48.3% ± 19.5%; P < 0.0001). Group II showed significantly impaired CVR (odds ratio 17.7, 95% confidence interval 1.82-171; P = 0.013) in multivariate analysis. The partial areas under the curve of the BeamSAT logistic model (0.843) were significantly larger than those of the conventional logistic model (0.626) over the range of high sensitivity (0.6-1) (P = 0.04). The incidence of postoperative HPS symptoms was significantly higher in Group II than in Group I (8/19 vs. 1/29; P = 0.001). BeamSAT MRI may be a valuable and non-invasive tool for assessing cerebral hemodynamics and predicting postoperative HPS.
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Affiliation(s)
- Yusuke Ikeuchi
- Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
| | - Masaaki Kohta
- Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan.
| | - Shunsuke Yamashita
- Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
| | - Shunsuke Yamanishi
- Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
| | - Yoji Yamaguchi
- Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
| | - Jun Tanaka
- Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan; Department of Neurosurgery, Konan Medical Center, 1-5-16 Kamokogahara, Higashinada-ku, Kobe, Hyogo 658-0064, Japan
| | - Kazuhiro Tanaka
- Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
| | - Hidehito Kimura
- Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
| | - Atsushi Fujita
- Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
| | - Kohkichi Hosoda
- Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan; Department of Neurosurgery, Myodani Hospital, 2350-2, Nashihara, Myodani-cho, Tarumi-ku, Kobe, Hyogo 655-0852 Japan
| | - Eiji Kohmura
- Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan; Department of Neurosurgery, Kinki Central Hospital of the Mutual Aid Association of Public School Teachers, 3-1 Kurumazuka, Itami, Hyogo 664-8533, Japan
| | - Takashi Sasayama
- Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
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Maruyama D, Iida H, Koshino K, Nakagawara J, Morita Y, Hashimura N, Mori H, Satow T, Takahashi JC, Fukuda T, Iihara K, Kataoka H. Comparative analysis of peri-nidal cerebral blood flow and metabolism using a novel quantitative 15O-PET method in patients with arteriovenous malformations. J Cereb Blood Flow Metab 2024:271678X241270416. [PMID: 39129183 DOI: 10.1177/0271678x241270416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
To effectively treat cerebral arteriovenous malformations (AVMs), peri-nidal flow regulation and metabolic status must be understood. In this study, we used 15O-oxygen positron emission tomography (PET) post-processing analysis to investigate vascular radioactivity in the nidal region of AVMs. Single-dynamic PET imaging was performed on seven unruptured AVM patients during the sequential inhalation of 15O2 and C15O2. A previously validated dual-tracer basis function method (DBFM) was employed to calculate parametric images. The results of our study were as follows. First, in remote and contralateral AVM regions, DBFM and a previous approach of dual-tracer autoradiography (DARG) showed strong positive correlations in cerebral blood flow (CBF), cerebral oxygen metabolism rate (CMRO2), and oxygen extraction fraction. Second, peri-nidal CBF and CMRO2 correlation was lower, and overestimation occurred with DARG compared to with DBFM. Third, on comparing DBFM to quantitative 123I-iodoamphetamine single-photon emission computed tomography (SPECT), CBF correlated significantly. In contrast, the correlation between DARG and quantitative 123I-iodoamphetamine-SPECT was weaker in the peri-nidal regions. Fourth, analysis of tissue time-activity curves demonstrated good reproducibility using the novel formulation in the control, peri-nidus, and core nidal regions, indicating the adequacy of this approach. Overall, the DBFM approach holds promise for assessing haemodynamic alterations in patients with AVMs.
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Affiliation(s)
- Daisuke Maruyama
- Department of Neurosurgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Hidehiro Iida
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Investigative Radiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kazuhiro Koshino
- Department of Investigative Radiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Jyoji Nakagawara
- Department of Neurosurgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yoshiaki Morita
- Department of Radiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Naoki Hashimura
- Department of Neurosurgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Hisae Mori
- Department of Neurosurgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Tetsu Satow
- Department of Neurosurgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Jun C Takahashi
- Department of Neurosurgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Tetsuya Fukuda
- Department of Radiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Koji Iihara
- Department of Neurosurgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Hiroharu Kataoka
- Department of Neurosurgery, National Cerebral and Cardiovascular Center, Osaka, Japan
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Yoshioka H, Wakai T, Hashimoto K, Tateoka T, Fukuda N, Horiuchi R, Umeda T, Onishi H, Kinouchi H. Iodine-123-Iomazenil Single-Photon Emission Computed Tomography Revealed Recovery of Neuronal Viability in Association With Improvement of Cognitive Dysfunction After Revascularization in Moyamoya Disease. Neurosurgery 2024:00006123-990000000-01296. [PMID: 39041800 DOI: 10.1227/neu.0000000000003127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 06/18/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Recent studies indicate that 123I-iomazenil (123I-IMZ) single-photon emission computed tomography (SPECT) can demonstrate neuronal viability. Although cognitive dysfunction has been recognized as an important issue in adult patients with moyamoya disease (MMD), no standard neuroradiological methods to define such conditions have been established. We examined the relationship between cognitive function and 123I-IMZ SPECT before and after revascularization in patients with MMD. METHODS The study participants were 16 adult patients with MMD whose cerebrovascular reactivities were decreased only on the surgical sides of combined revascularization. Cognitive function was examined using the Mini-Mental State Examination (MMSE; cutoff: 27) and the Frontal Assessment Battery (FAB; cutoff: 16) before and at 3 to 6 months after surgery. 123I-iodoamphetamine (123I-IMP) SPECT with acetazolamide challenge and 123I-IMZ SPECT were performed concurrently while evaluating cognitive function. The radioreactivities of 123I-IMZ SPECT in regions with decreased cerebrovascular reactivities on 123I-IMP SPECT were investigated using affected-to-contralateral side asymmetry ratio (IMZ-ACR). RESULTS Twelve patients showed normal cognitive function (MMSE: 29.8 ± 0.4, FAB: 18 ± 0) before surgery. No evident laterality of 123I-IMZ uptake was seen (IMZ-ACR: 0.98 ± 0.04). Neither cognitive function nor 123I-IMZ SPECT worsened after surgery (MMSE: 29.8 ± 0.3, FAB: 18 ± 0, IMZ-ACR: 1.00 ± 0.04). By contrast, 4 patients presented cognitive dysfunction (MMSE: 24.3 ± 3.9, FAB: 14.8 ± 2.7) before revascularization. Preoperative imaging of these patients showed decreased 123I-IMZ uptake, and their IMZ-ACRs (0.83 ± 0.08) were significantly lower than those of the normal group. After revascularization, cognitive functions and 123I-IMZ uptake tended to ameliorate (MMSE: 27.5 ± 1.7, FAB: 16.3 ± 2.2, IMZ-ACR: 0.94 ± 0.09). CONCLUSION Preoperative cognitive function was associated with 123I-IMZ uptake in adult patients with MMD. After revascularization, cognitive function could be recovered in the viable areas of the brain, which is consistent with 123I-IMZ SPECT findings.
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Affiliation(s)
- Hideyuki Yoshioka
- Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Takuma Wakai
- Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Koji Hashimoto
- Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Toru Tateoka
- Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Norito Fukuda
- Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Ryo Horiuchi
- Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Takako Umeda
- Department of Radiology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Hiroshi Onishi
- Department of Radiology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Hiroyuki Kinouchi
- Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
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Kikuchi K, Togao O, Yamashita K, Isoda T, Nishimura A, Arimura K, Nakamizo A, Yoshimoto K, Ishigami K. Brain volume measured by synthetic magnetic resonance imaging in adult moyamoya disease correlates with cerebral blood flow and brain function. Sci Rep 2024; 14:5468. [PMID: 38443400 PMCID: PMC10914740 DOI: 10.1038/s41598-024-56210-2] [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: 12/14/2023] [Accepted: 03/04/2024] [Indexed: 03/07/2024] Open
Abstract
Moyamoya disease (MMD) is characterized by progressive arterial occlusion, causing chronic hemodynamic impairment, which can reduce brain volume. A novel quantitative technique, synthetic magnetic resonance imaging (SyMRI), can evaluate brain volume. This study aimed to investigate whether brain volume measured with SyMRI correlated with cerebral blood flow (CBF) and brain function in adult MMD. In this retrospective study, 18 adult patients with MMD were included. CBF was measured using iodine-123-N-isopropyl-p-iodoamphetamine single photon emission computed tomography. Cerebrovascular reactivity (CVR) to acetazolamide challenge was also evaluated. Brain function was measured using the Wechsler Adult Intelligence Scales (WAIS)-III/IV and the WAIS-R tests. Gray matter (GM), white matter, and myelin-correlated volumes were evaluated in six areas. Resting CBF was positively correlated with GM fractions in the right anterior cerebral arterial and right middle cerebral arterial (MCA) territories. CVR was positively correlated with GM fraction in the right posterior cerebral arterial (PCA) territory. Full-Scale Intelligence Quotient and Verbal Comprehension Index scores were marginally positively correlated with GM fractions in the left PCA territory. Processing Speed Index score was marginally positively correlated with GM fraction in the right MCA territory. The SyMRI-measured territorial GM fraction correlated with CBF and brain function in patients with MMD.
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Affiliation(s)
- Kazufumi Kikuchi
- Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Osamu Togao
- Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Koji Yamashita
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Takuro Isoda
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Ataru Nishimura
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Koichi Arimura
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Akira Nakamizo
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Koji Yoshimoto
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kousei Ishigami
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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Kikuchi T, Takagi Y, Nakagawara J, Ueno T, Ubukata S, Houkin K, Araki Y, Takahashi JC, Nakase H, Murai T, Miyamoto S. Neuronal Loss in the Bilateral Medial Frontal Lobe Revealed by 123I-iomazenil Single-photon Emission Computed Tomography in Patients with Moyamoya Disease: The First Report from Cognitive Dysfunction Survey of Japanese Patients with Moyamoya Disease (COSMO-Japan Study). Neurol Med Chir (Tokyo) 2023; 63:334-342. [PMID: 37164699 PMCID: PMC10482485 DOI: 10.2176/jns-nmc.2023-0041] [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: 02/27/2023] [Accepted: 03/13/2023] [Indexed: 05/12/2023] Open
Abstract
Cognitive impairment in adult patients with moyamoya disease (MMD) is sometimes overlooked and can occur in patients with no ischemic or hemorrhagic lesions. Better profiling and reliable diagnostic methods that characterize the group and associate the impairments and pathology of MMD are required in order to deliver appropriate treatments and support. The potential of 123I-iomazenil single-photon emission computed tomography (SPECT) for this issue has been reported in some studies, but the universality of this method remains unclear. A multicenter study of adult patients (aged 18-60 years) with MMD who experienced difficulties in social lives despite normal activities of daily living was implemented to delineate the common characteristics of this group of patients. In this study, iomazenil SPECT, besides patient characteristics, cognitive functions, and conventional imaging, was acquired to examine whether this method is suitable as a universal diagnostic tool. A total of 36 patients from 12 institutes in Japan were included in this study. Domain scores of world health organization quality of life 26 indicated low self-rating in physical health and psychological domains. The percentages of patients who had <85 in each index were 27.8%-33.3% in the WAIS-III and 16.7%-47.2% in the Wechsler Memory Scale-Revised. The group analysis of iomazenil SPECT demonstrated a decreased accumulation in the bilateral medial frontal areas in comparison with the normal control, whereas there were no specific characteristics on conventional imaging in the cohort. Iomazenil SPECT is a possible universal diagnostic method for the extraction of patients with cognitive impairment in MMD.
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Affiliation(s)
- Takayuki Kikuchi
- Department of Neurosurgery, Kyoto University Graduate School of Medicine
| | - Yasushi Takagi
- Department of Neurosurgery, Tokushima University Graduate School of Medicine
| | - Jyoji Nakagawara
- Department of Neurosurgery, National Cerebral and Cardiovascular Center
| | - Tsukasa Ueno
- Integrated Clinical Education Center, Kyoto University Hospital
- Department of Psychiatry, Kyoto University Graduate School of Medicine
| | - Shiho Ubukata
- Medical Innovation Center, Kyoto University Graduate School of Medicine
| | | | - Yoshio Araki
- Department of Neurosurgery, Nagoya University Graduate School of Medicine
| | - Jun C Takahashi
- Department of Neurosurgery, National Cerebral and Cardiovascular Center
| | | | - Toshiya Murai
- Department of Psychiatry, Kyoto University Graduate School of Medicine
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine
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Murata T, Hayashi Y, Onoguchi M, Shibutani T, Iimori T, Sawada K, Umezawa T, Masuda Y, Uno T. Optimization of the Attenuation Coefficient for Chang Attenuation Correction in 123I Brain Perfusion SPECT. J Nucl Med Technol 2023; 51:49-56. [PMID: 36750381 DOI: 10.2967/jnmt.122.264990] [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: 10/04/2022] [Revised: 01/17/2023] [Accepted: 01/17/2023] [Indexed: 02/09/2023] Open
Abstract
N-isopropyl-p-123I-iodoamphetamine brain perfusion SPECT has been used with various attenuation coefficients (μ-values); however, optimization is required. This study aimed to determine the optimal μ-value (μopt-value) for Chang attenuation correction (AC) using clinical data by comparing the Chang method and CT-based AC. Methods: We used 100 patients (reference group, 60; disease group, 40) who underwent N-isopropyl-p-123I-iodoamphetamine SPECT. SPECT images of the reference group were obtained to calculate the AC using the Chang method (μ-values, 0.07-0.20; 0.005 interval) and the CT-based method, both without scatter correction (SC) and with SC. The μopt-value with the smallest mean percentage error for the brain regions of the reference group was calculated. Agreement between the Chang and CT-based methods applying the μopt-value was evaluated using Bland-Altman analysis. Additionally, the percentage error in the region of hypoperfusion in the diseased group was compared with the percentage error in the same region in the reference group when the μopt-value was applied. Results: The μopt-values were 0.140 for Chang without SC and 0.160 for Chang with SC. In the Chang method, with the μopt-value applied, fixed and proportional biases were observed in the Bland-Altman analysis (both P < 0.05), and there was a tendency for the percentage error to be underestimated in the limbic regions and overestimated in the central brain regions. There was no significant difference between the disease group and the reference group in the region of hypoperfusion in either Chang without SC or Chang with SC. Conclusion: The present study revealed that the μopt-values of the Chang method are 0.140 without SC and 0.160 with SC.
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Affiliation(s)
- Taisuke Murata
- Department of Radiology, Chiba University Hospital, Chiba, Japan.,Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan; and
| | - Yuri Hayashi
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan; and
| | - Takayuki Shibutani
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan; and
| | - Takashi Iimori
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Koichi Sawada
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Tetsuro Umezawa
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Yoshitada Masuda
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Takashi Uno
- Department of Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
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Miyake S, Takahashi K, Nakai Y, Amano Y, Yamamoto R, Amari K, Hara H, Johkura K. Visual suppression of vestibulo-ocular reflex in patients treated with carotid artery revascularization: A potential biomarker for cerebral perfusion. J Neurol Sci 2023; 445:120534. [PMID: 36587563 DOI: 10.1016/j.jns.2022.120534] [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: 10/20/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are common treatments for ischemic stroke prevention in patients with carotid artery stenosis. However, the beneficial effects of CEA/CAS for cerebral hypoperfusion due to carotid artery stenosis have yet to be fully established. As dizziness is a common symptom in patients with carotid artery stenosis, we aimed to evaluate the effects of CEA/CAS on cerebral function in patients with carotid artery stenosis, using equilibrium function tests. METHODS This prospective observational cohort study included 50 patients who had carotid artery stenosis and were scheduled to undergo CEA or CAS. Before CEA/CAS, we quantitatively evaluated the vestibulo-ocular reflex (VOR) and vestibular evoked myogenic potential (VEMP), as indicators of brainstem/inner ear functions related to balance, and visual suppression of VOR, as an indicator of cerebral control over the brainstem reflex related to balance. These were then compared with supratentorial cerebral blood flow (CBF). Changes in VOR, VEMP, visual suppression of VOR, CBF, and dizziness after CEA/CAS were also evaluated. RESULTS The visual suppression rates of VOR correlated with supratentorial CBFs before CEA/CAS (correlation coefficient = 0.47, p = 0.003). The visual suppression rates of VOR (p < 0.001) and supratentorial CBFs (p = 0.003) were improved by CEA/CAS, while VOR and VEMP did not change. Symptoms of dizziness improved after CEA/CAS. CONCLUSIONS Our results suggest that visual suppression of the VOR may be a novel and practical marker for the beneficial effects of CEA/CAS on supratentorial cerebral function.
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Affiliation(s)
- Shigeta Miyake
- Department of Neurosurgery, Yokohama Brain and Spine Center, Yokohama, Japan
| | - Koji Takahashi
- Department of Clinical Laboratory, Yokohama Brain and Spine Center, Yokohama, Japan
| | - Yasunobu Nakai
- Department of Neurosurgery, Yokohama Brain and Spine Center, Yokohama, Japan
| | - Yu Amano
- Department of Neurology, Yokohama Brain and Spine Center, Yokohama, Japan
| | - Ryoo Yamamoto
- Department of Neurology, Yokohama Brain and Spine Center, Yokohama, Japan
| | - Kazumitsu Amari
- Department of Neurosurgery, Yokohama Brain and Spine Center, Yokohama, Japan
| | - Hiroya Hara
- Department of Clinical Laboratory, Yokohama Brain and Spine Center, Yokohama, Japan
| | - Ken Johkura
- Department of Neurology, Yokohama Brain and Spine Center, Yokohama, 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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Kato H, Nakagawara J, Hachisuka K, Hatazawa J, Ikoma K, Suehiro E, Iida H, Ogasawara K, Iizuka O, Ishiai S, Ichikawa T, Nariai T, Okazaki T, Shiga T, Mori E. Impaired neuronal integrity in traumatic brain injury detected by 123I-iomazenil single photon emission computed tomography and MRI. J Cereb Blood Flow Metab 2022; 42:2245-2254. [PMID: 35796498 PMCID: PMC9670011 DOI: 10.1177/0271678x221113001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This study was aiming at investigating the extent of neuronal damage in cases of traumatic brain injury (TBI) with diffuse axonal injury (DAI) using 123I-iomazenil(IMZ) SPECT and MRI. We compared the findings in 31 patients with TBI without any major focal brain lesions and 25 age-matched normal controls. Subjects underwent 123I-IMZ SPECT and MRI, and also assessment by cognitive function tests. The partial volume effect of 123I-IMZ SPECT was corrected using MRI. In the patients with TBI, decreased spatial concentration of 123I-IMZ binding was detected in the medial frontal/orbitofrontal cortex, posterior cingulate gyrus, cuneus, precuneus, and superior region of the cerebellum. ROC analysis of 123I-IMZ SPECT for the detection of neuronal injury showed a high diagnostic ability of 123I-IMZ binding density for TBI in these areas. The decreased 123I-IMZ uptake density in the cuneus and precuneus was associated with cognitive decline after the injury. In the patients with TBI, brain atrophy was detected in the frontal lobe, anterior temporal and parietal cortex, corpus callosum, and posterior part of the cerebellum. Evaluation of the neuronal integrity by 123I-IMZ SPECT and MRI provides important information for the diagnosis and pathological interpretation in cases of TBI with DAI.
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Affiliation(s)
- Hiroki Kato
- Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Jyoji Nakagawara
- Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Japan
| | - Kenji Hachisuka
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Jun Hatazawa
- Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Katsunori Ikoma
- Department of Rehabilitation Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Eiichi Suehiro
- Department of Neurosurgery, Yamaguchi University School of Medicine, Ube, Japan
| | - Hidehiko Iida
- Department of Investigative Radiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kuniaki Ogasawara
- Department of Neurosurgery, Iwate Medical University, Morioka, Japan
| | - Osamu Iizuka
- Department of Behavioral Neurology & Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Sumio Ishiai
- Department of Rehabilitation Medicine, Sapporo Medical University, Sapporo, Japan
| | - Tadashi Ichikawa
- Department of Neurology, Saitama Rehabilitation Center, Ageo, Japan
| | - Tadashi Nariai
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tetsuya Okazaki
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tohru Shiga
- Department of Diagnostic Imaging, Hokkaido University, Sapporo, Japan
| | - Etsuro Mori
- Department of Behavioral Neurology & Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan
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10
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Generative adversarial network-created brain SPECTs of cerebral ischemia are indistinguishable to scans from real patients. Sci Rep 2022; 12:18787. [PMID: 36335166 PMCID: PMC9637159 DOI: 10.1038/s41598-022-23325-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 10/29/2022] [Indexed: 11/06/2022] Open
Abstract
Deep convolutional generative adversarial networks (GAN) allow for creating images from existing databases. We applied a modified light-weight GAN (FastGAN) algorithm to cerebral blood flow SPECTs and aimed to evaluate whether this technology can generate created images close to real patients. Investigating three anatomical levels (cerebellum, CER; basal ganglia, BG; cortex, COR), 551 normal (248 CER, 174 BG, 129 COR) and 387 pathological brain SPECTs using N-isopropyl p-I-123-iodoamphetamine (123I-IMP) were included. For the latter scans, cerebral ischemic disease comprised 291 uni- (66 CER, 116 BG, 109 COR) and 96 bilateral defect patterns (44 BG, 52 COR). Our model was trained using a three-compartment anatomical input (dataset 'A'; including CER, BG, and COR), while for dataset 'B', only one anatomical region (COR) was included. Quantitative analyses provided mean counts (MC) and left/right (LR) hemisphere ratios, which were then compared to quantification from real images. For MC, 'B' was significantly different for normal and bilateral defect patterns (P < 0.0001, respectively), but not for unilateral ischemia (P = 0.77). Comparable results were recorded for LR, as normal and ischemia scans were significantly different relative to images acquired from real patients (P ≤ 0.01, respectively). Images provided by 'A', however, revealed comparable quantitative results when compared to real images, including normal (P = 0.8) and pathological scans (unilateral, P = 0.99; bilateral, P = 0.68) for MC. For LR, only uni- (P = 0.03), but not normal or bilateral defect scans (P ≥ 0.08) reached significance relative to images of real patients. With a minimum of only three anatomical compartments serving as stimuli, created cerebral SPECTs are indistinguishable to images from real patients. The applied FastGAN algorithm may allow to provide sufficient scan numbers in various clinical scenarios, e.g., for "data-hungry" deep learning technologies or in the context of orphan diseases.
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11
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Tsukinaga A, Yoshitani K, Ozaki T, Takahashi JC, Ogata S, Ohnishi Y. Quantitative regional cerebral blood flow measurement using near-infrared spectroscopy and indocyanine green in patients undergoing superficial temporal to middle cerebral artery bypass for moyamoya disease: a novel method using a frequency filter. J Clin Monit Comput 2022; 37:421-429. [PMID: 36167879 DOI: 10.1007/s10877-022-00916-z] [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: 06/30/2022] [Accepted: 09/07/2022] [Indexed: 11/30/2022]
Abstract
Measuring regional cerebral blood flow (rCBF) after revascularization for moyamoya disease, as a type of ischemic cerebrovascular disease, is crucial. This study aims to validate our novel technology that combines near-infrared spectroscopy (NIRS) with a frequency filter to extract the arterial component. We measured rCBF before and after revascularization for moyamoya disease and at the end of the surgery using NIRO-200NX (Hamamatsu Photonics, Japan) and indocyanine green (ICG). rCBF was calculated using Fick's principle, change in arterial ICG concentrations, and maximum arterial ICG concentration. rCBF measured with NIRS (rCBF_N) was compared with pre- and postoperative rCBF measured with SPECT (rCBF_S). Thirty-four procedures were analyzed. rCBF_N increased from baseline to end of the surgery (mean difference (MD), 2.99 ml/min/100 g; 95% confidence interval (CI), 0.40-5.57 ml/min/100 g on the diseased side; MD, 4.94 ml/min/100 g; 95% CI, 2.35-7.52 ml/min/100 g on the non-diseased side). Similar trends were observed for rCBF_S (MD, 3.98 ml/min/100 g; 95% CI, 2.30-5.67 ml/min/100 g on the diseased side; MD, 2.77 ml/min/100 g; 95% CI, 1.09-4.45 ml/min/100 g on the non-diseased side). Intraclass correlations 3 (ICC3s) between rCBF_N and rCBF_S were weak on the diseased side (ICC3, 0.25; 95% CI, -0.03-0.5; p = 0.07) and the non-diseased side (ICC3, 0.24; 95% CI, -0.05-0.5; p = 0.08). rCBF measurements based on this novel method were weakly correlated with rCBF measurements with SPECT.
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Affiliation(s)
- Akito Tsukinaga
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, 6-1 Kishibeshimmachi, SuitaOsaka, 564-8565, Japan
| | - Kenji Yoshitani
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, 6-1 Kishibeshimmachi, SuitaOsaka, 564-8565, Japan.
| | - Takeo Ozaki
- Systems Division, Hamamatsu Photonics K.K, Hamamatsu, Japan
| | - Jun C Takahashi
- Department of Neurosurgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yoshihiko Ohnishi
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, 6-1 Kishibeshimmachi, SuitaOsaka, 564-8565, Japan
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12
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Tani K, Mio M, Toyofuku T, Maeda T, Inoue T, Nakamura H. [Feasibility of Cerebrovascular Reserve Assessment Using Stretched Exponential Model in Major Cerebral Artery Steno-occlusive Disease: Comparison with SPECT]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2022; 78:819-828. [PMID: 35753804 DOI: 10.6009/jjrt.2022-1262] [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] [Indexed: 06/15/2023]
Abstract
PURPOSE To clarify whether diffusion-weighted imaging using stretched exponential model can assess cerebrovascular reserve (CVR) in patients with major cerebral artery steno-occlusive disease, we compared stretched exponential parameters and single-photon emission computed tomography (SPECT). METHODS Twenty-nine patients with unilateral major cerebral artery steno-occlusive disease (25 men and 4 women; age, 69±11 years) were analyzed in this study. The patients were divided into three groups: normal CVR (CVR≥30%), moderate CVR (10%≤CVR<30%), and severe CVR (CVR<10%). The distributed diffusion coefficient (DDC) and heterogeneity index (α) from the stretched exponential model, apparent diffusion coefficient (ADC) from the monoexponential model, and CVR and resting cerebral blood flow (CBF) from SPECT were measured in the bilateral middle cerebral artery territories, and ipsilateral-to-contralateral ratios (rDDC, rα, rADC, and rCBF) were obtained. RESULTS The rDDC values in severe CVR were significantly higher than those in normal CVR (P=0.003). The rDDC values were significantly negatively correlated with ipsilateral CVR (rho=-0.31, P=0.009). The rDDC values were not significantly correlated with rCBF (P=0.34). CONCLUSION We have shown that elevated rDDC values are associated with impaired CVR. Our results suggest that diffusion-weighted imaging using stretched exponential model has a potential to evaluate hemodynamic impairment.
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Affiliation(s)
- Kazuki Tani
- Department of Radiology, Fukuoka University Chikushi Hospital
| | - Motohira Mio
- Department of Radiology, Fukuoka University Chikushi Hospital
| | - Tatsuo Toyofuku
- Department of Radiology, Fukuoka University Chikushi Hospital
| | - Toshihiro Maeda
- Department of Radiology, Fukuoka University Chikushi Hospital
| | - Toshiro Inoue
- Department of Radiology, Fukuoka University Chikushi Hospital
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13
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Yamashita S, Kohta M, Hosoda K, Tanaka J, Matsuo K, Kimura H, Tanaka K, Fujita A, Sasayama T. Absence of the Anterior Communicating Artery on Selective MRA is Associated with New Ischemic Lesions on MRI after Carotid Revascularization. AJNR Am J Neuroradiol 2022; 43:1124-1130. [PMID: 35835591 PMCID: PMC9575412 DOI: 10.3174/ajnr.a7570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 05/17/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE ICA-selective MRA using a pencil beam presaturation pulse can accurately visualize anterior communicating artery flow. We evaluated the impact of anterior communicating artery flow on the perioperative hemodynamic status and new ischemic lesions after carotid revascularization. MATERIALS AND METHODS Eighty-three patients with carotid artery stenosis were included. We assessed anterior communicating artery flow using ICA-selective MRA. The preoperative hemodynamic status was measured using SPECT. We also measured the change in regional cerebral oxygen saturation after temporary ICA occlusion. New ischemic lesions were evaluated by DWI on the day after treatment. RESULTS Anterior communicating artery flow was detected in 61 patients, but it was not detected in 22 patients. Preoperative cerebrovascular reactivity was significantly higher in patients with (versus without) anterior communicating artery flow with a mean peak systolic velocity of ≥200 cm/s (39.6% [SD, 23.8%] versus 25.2% [SD, 16.4%]; P = .030). The decrease in mean regional cerebral oxygen saturation was significantly greater in patients without (versus with) anterior communicating artery flow (8.5% [SD, 5.6%] versus 3.7% [SD, 3.8%]; P = .002). New ischemic lesions after the procedure were observed in 23 patients. The multivariate logistic regression analysis revealed that anterior communicating artery flow (OR, 0.07; 95% CI, 0.012-0.45; P = .005) was associated with new ischemic lesions. CONCLUSIONS The absence of anterior communicating artery flow influenced the perioperative hemodynamic status in patients with carotid stenosis and was associated with an increased incidence of new ischemic lesions after carotid revascularization.
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Affiliation(s)
- S Yamashita
- From the Department of Neurosurgery (S.Y., M.K., J.T., K.M., H.K., K.T., A.F., T.S.), Kobe University Graduate School of Medicine, Kobe, Japan
| | - M Kohta
- From the Department of Neurosurgery (S.Y., M.K., J.T., K.M., H.K., K.T., A.F., T.S.), Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Hosoda
- Department of Neurosurgery (K.H.), Kobe City Nishi-Kobe Medical Center, Kobe, Japan
| | - J Tanaka
- From the Department of Neurosurgery (S.Y., M.K., J.T., K.M., H.K., K.T., A.F., T.S.), Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Matsuo
- From the Department of Neurosurgery (S.Y., M.K., J.T., K.M., H.K., K.T., A.F., T.S.), Kobe University Graduate School of Medicine, Kobe, Japan
| | - H Kimura
- From the Department of Neurosurgery (S.Y., M.K., J.T., K.M., H.K., K.T., A.F., T.S.), Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Tanaka
- From the Department of Neurosurgery (S.Y., M.K., J.T., K.M., H.K., K.T., A.F., T.S.), Kobe University Graduate School of Medicine, Kobe, Japan
| | - A Fujita
- From the Department of Neurosurgery (S.Y., M.K., J.T., K.M., H.K., K.T., A.F., T.S.), Kobe University Graduate School of Medicine, Kobe, Japan
| | - T Sasayama
- From the Department of Neurosurgery (S.Y., M.K., J.T., K.M., H.K., K.T., A.F., T.S.), Kobe University Graduate School of Medicine, Kobe, Japan
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14
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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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15
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Yuhn C, Oshima M, Chen Y, Hayakawa M, Yamada S. Uncertainty quantification in cerebral circulation simulations focusing on the collateral flow: Surrogate model approach with machine learning. PLoS Comput Biol 2022; 18:e1009996. [PMID: 35867968 PMCID: PMC9307280 DOI: 10.1371/journal.pcbi.1009996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/07/2022] [Indexed: 11/18/2022] Open
Abstract
Collateral circulation in the circle of Willis (CoW), closely associated with disease mechanisms and treatment outcomes, can be effectively investigated using one-dimensional–zero-dimensional hemodynamic simulations. As the entire cardiovascular system is considered in the simulation, it captures the systemic effects of local arterial changes, thus reproducing collateral circulation that reflects biological phenomena. The simulation facilitates rapid assessment of clinically relevant hemodynamic quantities under patient-specific conditions by incorporating clinical data. During patient-specific simulations, the impact of clinical data uncertainty on the simulated quantities should be quantified to obtain reliable results. However, as uncertainty quantification (UQ) is time-consuming and computationally expensive, its implementation in time-sensitive clinical applications is considered impractical. Therefore, we constructed a surrogate model based on machine learning using simulation data. The model accurately predicts the flow rate and pressure in the CoW in a few milliseconds. This reduced computation time enables the UQ execution with 100 000 predictions in a few minutes on a single CPU core and in less than a minute on a GPU. We performed UQ to predict the risk of cerebral hyperperfusion (CH), a life-threatening condition that can occur after carotid artery stenosis surgery if collateral circulation fails to function appropriately. We predicted the statistics of the postoperative flow rate increase in the CoW, which is a measure of CH, considering the uncertainties of arterial diameters, stenosis parameters, and flow rates measured using the patients’ clinical data. A sensitivity analysis was performed to clarify the impact of each uncertain parameter on the flow rate increase. Results indicated that CH occurred when two conditions were satisfied simultaneously: severe stenosis and when arteries of small diameter serve as the collateral pathway to the cerebral artery on the stenosis side. These findings elucidate the biological aspects of cerebral circulation in terms of the relationship between collateral flow and CH.
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Affiliation(s)
- Changyoung Yuhn
- Department of Mechanical Engineering, The University of Tokyo, Meguro-ku, Tokyo, Japan
| | - Marie Oshima
- Interfaculty Initiative in Information Studies, The University of Tokyo, Meguro-ku, Tokyo, Japan
- * E-mail:
| | - Yan Chen
- Interfaculty Initiative in Information Studies, The University of Tokyo, Meguro-ku, Tokyo, Japan
| | - Motoharu Hayakawa
- Department of Neurosurgery, Fujita Health University, Toyoake, Aichi, Japan
| | - Shigeki Yamada
- Interfaculty Initiative in Information Studies, The University of Tokyo, Meguro-ku, Tokyo, Japan
- Department of Neurosurgery, Shiga University of Medical Science, Otsu, Shiga, Japan
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16
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Efficacy of pretreatment with the free radical scavenger, edaravone, for prevention of cerebral hyperperfusion after carotid artery stenting: A single-center randomized controlled trial. INTERDISCIPLINARY NEUROSURGERY 2021. [DOI: 10.1016/j.inat.2021.101092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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17
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Wakabayashi Y, Uchiyama M, Daisaki H, Matsumoto M, Sakamoto M, Kashikura K. Investigation of the new non-invasive semi-quantitative method of 123I-IMP pediatric cerebral perfusion SPECT. PLoS One 2020; 15:e0241987. [PMID: 33166343 PMCID: PMC7652270 DOI: 10.1371/journal.pone.0241987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 10/26/2020] [Indexed: 11/19/2022] Open
Abstract
In pediatric cases requiring quantification of cerebral blood flow (CBF) using 123I-N-isopropyl-p-iodoamphetamine (123I-IMP) single-photon emission computed tomography (SPECT), arterial blood sampling is sometimes impossible due to issues such as movement, crying, or body motion. If arterial blood sampling fails, quantitative diagnostic assessment becomes impossible despite radiation exposure. We devised a new easy non-invasive microsphere (e-NIMS) method using whole-body scan data. This method can be used in conjunction with autoradiography (ARG) and can provide supportive data for invasive CBF quantification. In this study, we examined the usefulness of e-NIMS for pediatric cerebral perfusion semi-quantitative SPECT and compared it with the invasive ARG. The e-NIMS estimates cardiac output (CO) using whole-body acquisition data after 123I-IMP injection and the body surface area from calculation formula. A whole-body scan was performed 5 minutes after the 123I-IMP injection and CO was estimated by region of interest (ROI) counts measured for the whole body, lungs, and brain using the whole-body anterior image. The mean CBF (mCBF) was compared with that acquired via ARG in 115 pediatric patients with suspected cerebrovascular disorders (age 0-15 years). Although the mCBF estimated by the e-NIMS indicated a slight deviation in the extremely low- or high-mCBF cases when compared with the values acquired using the invasive ARG, there was a good correlation between the two methods (r = 0.799; p < 0.001). There were no significant differences in the mCBF values based on physical features, such as patients' height, weight, and age. Our findings suggest that 123I-IMP brain perfusion SPECT with e-NIMS is the simplest semi-quantitative method that can provide supportive data for invasive CBF quantification. This method may be useful, especially in pediatric brain perfusion SPECT, when blood sampling or identifying pulmonary arteries for CO estimation using the graph plot method is difficult.
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Affiliation(s)
- Yasuharu Wakabayashi
- Division of Radiological Technology, Saitama Prefectural Children's Medical Center, Saitama, Saitama, Japan
- Graduate School of Radiological Technology, Gunma Prefectural College of Health Science, Maebashi, Gunma, Japan
| | - Mayuki Uchiyama
- Division of Radiology, Tokyo Jikeikai Medical University, Minato-ku, Tokyo, Japan
| | - Hiromitsu Daisaki
- Graduate School of Radiological Technology, Gunma Prefectural College of Health Science, Maebashi, Gunma, Japan
| | - Makoto Matsumoto
- Division of Radiological Technology, Saitama Prefectural Children's Medical Center, Saitama, Saitama, Japan
| | - Masafumi Sakamoto
- Division of Radiological Technology, Saitama Prefectural Respiratory and Cardiovascular Center, Kumagaya, Saitama, Japan
| | - Kenichi Kashikura
- Graduate School of Radiological Technology, Gunma Prefectural College of Health Science, Maebashi, Gunma, Japan
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18
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Wan Y, Wang H, Wang D, Tian H, Zuo J, Fang Q. The safety and efficacy of staged angioplasty for treating carotid stenosis with a high risk of hyperperfusion: A single-center retrospective study. Interv Neuroradiol 2020; 26:637-642. [PMID: 32772622 DOI: 10.1177/1591019920946507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Hyperperfusion syndrome (HPS) following carotid artery stenting (CAS) is a rare but life-threatening complication. Staged angioplasty (SAP) is an alternative method that prevents HPS by preventing a sudden increase in cerebral blood flow. In this study, we investigated the safety and efficacy of SAP. METHODS A total of 114 patients with carotid stenosis underwent CAS treatment in our hospital between September 2014 and September 2019. Patients with severe stenosis and poor collateral circulation shown on digital subtraction angiography (DSA) and hypoperfusion of the ipsilateral diseased blood vessel shown on computed tomography perfusion (CTP) imaging were subjected to SAP treatment (the SAP group), and other patients received regular CAS treatment (the RS group). RESULTS Twenty-two patients (19.3%) with a high risk of HPS underwent SAP treatment, 1 of whom had carotid dissection after stage I balloon angioplasty and underwent regular CAS. This patient had HPS after surgery. None of the other patients in either group had HPS. One patient in the SAP group (4.5%) had hyperperfusion phenomenon (HPP) after stage II stenting, and 2 patients in the RS group (2.2%) had HPP. One patient in the SAP group (4.5%) and 4 patients in the RS group (4.3%) had symptomatic ischemic complications postoperatively. None of the differences between the 2 groups were statistically significant. Three patients had reduced modified Rankin Scale (mRS) scores at 90 days after discharge. CONCLUSION This research suggests that SAP appears to be an effective method to prevent HPS for patients with a high risk of HPS.
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Affiliation(s)
- Yue Wan
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, P.R. China.,Department of Neurology, The Third Hospital of Hubei Province, Wuhan, P.R. China
| | - Hui Wang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, P.R. China
| | - Dapeng Wang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, P.R. China
| | - Hao Tian
- Department of Neurology, The Third Hospital of Hubei Province, Wuhan, P.R. China
| | - Jing Zuo
- Department of Neurology, The Third Hospital of Hubei Province, Wuhan, P.R. China
| | - Qi Fang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, P.R. China
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Sato Y, Sugiyama T, Mizutani T. Whole-Field Indocyanine Green Intensity Analysis to Intraoperatively Predict Cerebral Hyperperfusion Syndrome Following Superficial Temporal Artery-Middle Cerebral Artery Bypass: A Retrospective Case-Control Study in 7-Year Experience With 112 Cases. Oper Neurosurg (Hagerstown) 2020; 18:652-659. [PMID: 31538195 DOI: 10.1093/ons/opz282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 07/10/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Intraoperative prediction of postoperative cerebral hyperperfusion syndrome (CHS) after cerebrovascular bypass surgery is challenging. OBJECTIVE To conduct a retrospective case-control study with indocyanine green (ICG) intensity analysis of the superficial temporal artery-middle cerebral artery (STA-MCA) bypass and investigate whether its washout pattern might be a marker for intraoperative prediction of CHS. METHODS Between 2012 and 2018, 6 of 112 patients (5.4%) that underwent STA-MCA bypass exhibited CHS. We selected 5 patients with CHS (3 with atherosclerotic cerebrovascular disease [ASCVD] and 2 with moyamoya) and 15 patients without CHS (60% ASCVD and 40% moyamoya) as a matched control group. During prebypass and postbypass, washout times (WTs) for the first 10%, 25%, 50%, and 75% of maximum ICG intensity measured in the whole-camera field were compared between groups. The changes in WT (ΔWT) from prebypass to postbypass for each ICG intensity level were compared between groups. The cutoff ΔWTs, sensitivities, and specificities were also calculated. RESULTS Postbypass WTs were significantly longer in the CHS group than the control group at all ICG intensities (P < .05). ΔWT was significantly greater in the CHS group than the control group for the first 10%, 25%, and 50% ICG intensities (P < .001). A cutoff ΔWT of ≥2.66 s for the first 50% ICG intensity showed a sensitivity of 100% and specificity of 100%. CONCLUSION We found that a ΔWT ≥2.66 s for the first 50% ICG intensity could be an intraoperative predictive factor for CHS.
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Affiliation(s)
- Yosuke Sato
- Department of Neurosurgery, School of Medicine, Showa University, Tokyo, Japan
| | - Tatsuya Sugiyama
- Department of Neurosurgery, School of Medicine, Showa University, Tokyo, Japan
| | - Tohru Mizutani
- Department of Neurosurgery, School of Medicine, Showa University, Tokyo, Japan
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Wong TH, Shagera QA, Ryoo HG, Ha S, Lee DS. Basal and Acetazolamide Brain Perfusion SPECT in Internal Carotid Artery Stenosis. Nucl Med Mol Imaging 2020; 54:9-27. [PMID: 32206127 PMCID: PMC7062956 DOI: 10.1007/s13139-019-00633-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 12/19/2019] [Accepted: 12/26/2019] [Indexed: 10/25/2022] Open
Abstract
Internal carotid artery (ICA) stenosis including Moyamoya disease needs revascularization when hemodynamic insufficiency is validated. Vascular reserve impairment was the key to find the indication for endarterectomy/bypass surgery in the atherosclerotic ICA stenosis and to determine the indication, treatment effect, and prognosis in Moyamoya diseases. Vascular reserve was quantitatively assessed by 1-day split-dose I-123 IMP basal/acetazolamide SPECT in Japan or by Tc-99m HMPAO SPECT in other countries using qualitative or semi-quantitative method. We summarized the development of 1-day basal/ acetazolamide brain perfusion SPECT for ICA stenosis, both quantitative and qualitative methods, and their methodological issues regarding (1) acquisition protocol; (2) qualitative assessment, either visual or deep learning-based; (3) clinical use for atherosclerotic ICA steno-occlusive diseases and mostly Moyamoya diseases; and (4) their impact on the choice of treatment options. Trials to use CT perfusion or perfusion MRI using contrast materials or arterial spin labeling were briefly discussed in their endeavor to use basal studies alone to replace acetazolamide-challenge SPECT. Theoretical and practical issues imply that basal perfusion evaluation, no matter how much sophisticated, will not disclose vascular reserve. Acetazolamide rarely causes serious adverse reactions but included fatality, and now, we need to monitor patients closely in acetazolamide-challenge studies.
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Affiliation(s)
- Teck Huat Wong
- Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yongon-Dong, Jongno-Gu, Seoul, 110-744 South Korea
- Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea
| | - Qaid Ahmed Shagera
- Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yongon-Dong, Jongno-Gu, Seoul, 110-744 South Korea
- Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea
| | - Hyun Gee Ryoo
- Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yongon-Dong, Jongno-Gu, Seoul, 110-744 South Korea
- Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea
| | - Seunggyun Ha
- Division of Nuclear Medicine Department of Radiology, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Dong Soo Lee
- Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yongon-Dong, Jongno-Gu, Seoul, 110-744 South Korea
- Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea
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21
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Murai S, Sugiu K, Hishikawa T, Hiramatsu M, Nishihiro S, Kidani N, Takahashi Y, Nishi K, Yamaoka Y, Date I. Safety and efficacy of staged angioplasty for patients at risk of hyperperfusion syndrome: a single-center retrospective study. Neuroradiology 2020; 62:503-510. [DOI: 10.1007/s00234-019-02343-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 12/05/2019] [Indexed: 10/25/2022]
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22
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Katano H, Nishikawa Y, Yamada H, Shibata T, Miyachi S, Mase M. Association of Superficial Temporal Artery Dilatation with Headache After Revascularization in Adult Moyamoya Disease. World Neurosurg 2019; 129:e594-e606. [PMID: 31158538 DOI: 10.1016/j.wneu.2019.05.228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 05/25/2019] [Accepted: 05/27/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND The underlying mechanisms of headache in adult moyamoya disease (MMD) are not clear. The aim of this study is to clarify the factors that are associated with headache in adult patients with MMD after superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis. METHODS We retrospectively analyzed the cases of 68 adult patients with MMD: 30 with surgery and 38 without surgery. Each STA-MCA anastomosis was performed by the standard technique. Magnetic resonance angiography (MRA) and single photon emission computed tomography were performed perioperatively. We stratified the intensity and frequency of the patients' headaches into 4 ranks. Pre- and postoperative STA diameters were retrospectively measured on digital subtraction angiography (DSA) and/or MRA. RESULTS In the surgery group, preoperative regional cerebral blood flow (rCBF) laterality and a postoperative rCBF increase >20% showed no significant difference between the patients with and without headache with a univariate analysis. The postoperative STA diameters of the distal branch (DSA) and main trunk (DSA/MRA) in the patients with headache were significantly larger than those of the patients without headache. The rate of postoperative increase of the STA diameters of the distal branch/main trunk was also significantly higher in the patients with headache than those without headache. A multivariate analysis showed that the standard regression coefficient β for sex, a >20% increase of postoperative rCBF, and the increase rate of the STA diameter of the distal branch shown by DSA was 0.37, 0.54, and 0.56, respectively. CONCLUSIONS The results of our analyses revealed that aside from ischemia, the postoperative increase rate of the STA may be a candidate reason for headache, especially in adult patients with MMD.
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Affiliation(s)
- Hiroyuki Katano
- Department of Neurosurgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Department of Medical informatics & Integrative Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
| | - Yusuke Nishikawa
- Department of Neurosurgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hiroshi Yamada
- Department of Neurosurgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Teishiki Shibata
- Department of Neurosurgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shigenori Miyachi
- Department of Central Radiology, Nagoya City University Hospital, Nagoya, Japan
| | - Mitsuhito Mase
- Department of Neurosurgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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23
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Tsuchitani T, Maeda Y, Oda M, Enoki T, Takahashi Y, Mitsuie C, Tanooka M, Kotoura N, Kitajima K. [Simulation at Incomplete Acquisition on Stress-rest Cerebral Blood Flow Quantitative Values One Day Method]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2018; 74:270-277. [PMID: 29563396 DOI: 10.6009/jjrt.2018_jsrt_74.3.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The QSPECT dual table autoradiography (DTARG) method can be used for quantitative determination of cerebral blood flow. We verified the influence on quantitative values obtained for cerebral blood flow in the case when usual acquisition was impossible and evaluated those values. Results obtained with an acquisition time of 30 min were considered to be true values, and the correlation and consistency with results of other times were evaluated. Values obtained with a shortened acquisition time showed a high correlation with the true value. As for consistency, there were differences among the various data collection intervals. Nevertheless, regardless of the use of a shortened acquisition time and the data acquisition interval, values obtained with the QSPECT program showed a high correlation with the true value. Based on our findings showing a high correlation, a quantitative evaluation of cerebral blood flow can be performed with the QSPECT DTARG method, even with complications, such as examination interruption, thus, it is considered to be a flexible method.
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Affiliation(s)
- Tatsuya Tsuchitani
- Department of Radiological Technology, Hyogo College of Medicine College Hospital
| | - Yoshihiro Maeda
- Department of Radiological Technology, Hyogo College of Medicine College Hospital
| | - Masahiko Oda
- Department of Radiological Technology, Hyogo College of Medicine College Hospital
| | - Takuya Enoki
- Department of Radiological Technology, Hyogo College of Medicine College Hospital
| | - Yoshiyuki Takahashi
- Department of Radiological Technology, Hyogo College of Medicine College Hospital
| | - Chiemi Mitsuie
- Department of Radiological Technology, Hyogo College of Medicine College Hospital
| | - Masao Tanooka
- Department of Radiotherapy, Takarazuka City Hospital
| | - Noriko Kotoura
- Department of Radiological Technology, Hyogo College of Medicine College Hospital
| | - Kazuhiro Kitajima
- Division of Nuclear Medicine and PET Center, Department of Radiology, Hyogo College of Medicine
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24
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Okazaki T, Irie S, Inagaki T, Saito O, Yamashina M, Hayase H, Nakagawa H, Nagahiro S, Saito K. Coloring Technique of Magnetic Resonance Angiography for Superficial Temporal Artery to Middle Cerebral Artery Bypass Surgery. World Neurosurg 2018; 112:e113-e118. [PMID: 29366994 DOI: 10.1016/j.wneu.2017.12.152] [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: 10/04/2017] [Accepted: 12/23/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Superficial temporal artery (STA)-to-middle cerebral artery (MCA) bypass is an established surgical technique for achieving revascularization. It is important to select the proper recipient artery of the MCA. Three-dimensional computed tomographic angiography (3D-CTA) and conventional angiography are useful in the selection process but need contrast agents. The authors have designed a coloring MRA technique that needs no agents to visualize the recipient artery. Retrospective evaluation of the efficacy and limitation for selection of the recipient artery and decision of the place and size of the craniotomy were carried out. METHODS The authors performed the coloring MRA before operation since January 2013. Ninety-two patients underwent STA-MCA bypass for atherosclerotic stenosis or occlusion of internal carotid artery (ICA), MCA with reference to the coloring MRA. To evaluate the efficacy of coloring MRA, the control group consisted of 75 patients who underwent STA-MCA bypass between January 2012 to November 2013 with reference to 3D-CTA. The size of craniotomy was retrospectively calculated and compared. RESULTS Neither additional craniotomy nor wrong selection of the recipient artery was done in either group. There was no significant difference in size between the 2 groups in both single and double bypass. CONCLUSIONS The coloring MRA technique was not inferior to 3D-CTA with respect to the size of craniotomy. This novel technique was found to be very helpful not only for the virtual identification of the proper recipient artery but also for preoperative simulation such as decisions about length of donor artery, location, and size of craniotomy.
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Affiliation(s)
- Toshiyuki Okazaki
- Department of Neurosurgery, Kushiro Kojinkai Memorial Hospital, Kushiro, Japan; Department of Neurosurgery, Tokushima University, Tokushima, Japan.
| | - Shinsuke Irie
- Department of Neurosurgery, Kushiro Kojinkai Memorial Hospital, Kushiro, Japan
| | - Toru Inagaki
- Department of Neurosurgery, Kushiro Kojinkai Memorial Hospital, Kushiro, Japan
| | - Osamu Saito
- Department of Neurosurgery, Kushiro Kojinkai Memorial Hospital, Kushiro, Japan
| | - Motoshige Yamashina
- Department of Neurosurgery, Kushiro Kojinkai Memorial Hospital, Kushiro, Japan
| | - Hitoshi Hayase
- Department of Neurosurgery, Kushiro Kojinkai Memorial Hospital, Kushiro, Japan
| | - Hiroshi Nakagawa
- Department of Neurosurgery, Kushiro Kojinkai Memorial Hospital, Kushiro, Japan
| | - Shinji Nagahiro
- Department of Neurosurgery, Tokushima University, Tokushima, Japan
| | - Koji Saito
- Department of Neurosurgery, Kushiro Kojinkai Memorial Hospital, Kushiro, Japan
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25
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Matsutomo N, Yamamoto T, Sato E. [Influence of Scintillation Camera Uniformity on Artifact Generation: A Simulation Study]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2018; 74:789-796. [PMID: 30122743 DOI: 10.6009/jjrt.2018_jsrt_74.8.789] [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] [Indexed: 06/08/2023]
Abstract
PURPOSE Non-uniformity of a scintillation camera can result in artifacts on planar, projection, and single-photon emission computed tomography (SPECT) images. The purpose of this study was to evaluate the effect of field uniformity on artifact generation. METHODS Using a simulation phantom, we investigated the relationship between non-uniformity of the image and artifacts on planar, projection, and SPECT images. All the non-uniformity images were generated by decreasing the photomultiplier tube sensitivity ranging from 0% to 10%. Quantitative analysis was performed using integral and differential uniformity. We also visually assessed artifact magnitude. RESULTS Integral and differential uniformity increased with decreasing the photomultiplier tube sensitivity and tended to be higher in SPECT images compared with planar and projection images. For visual assessment, mean scores in SPECT images were higher than in planar and projection images for artifact detection. CONCLUSIONS Our results indicated that decreasing field uniformity is expected to produce artifacts in planar and SPECT images. Also, SPECT images require very high-field uniformity.
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Affiliation(s)
- Norikazu Matsutomo
- Department of Medical Radiological Technology, Faculty of Health Sciences, Kyorin University
- Faculty of Health Sciences, Graduate School of Health Sciences, Kyorin University
| | - Tomoaki Yamamoto
- Department of Medical Radiological Technology, Faculty of Health Sciences, Kyorin University
- Faculty of Health Sciences, Graduate School of Health Sciences, Kyorin University
| | - Eisuke Sato
- Department of Medical Radiological Technology, Faculty of Health Sciences, Kyorin University
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26
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Miura M, Nakajima M, Fujimoto A, Shiraishi S, Liebeskind DS, Ando Y. Decreased Signal Intensity Ratio on MRA Reflects Misery Perfusion on SPECT in Patients with Intracranial Stenosis. J Neuroimaging 2017; 28:206-211. [DOI: 10.1111/jon.12489] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 10/24/2017] [Accepted: 11/11/2017] [Indexed: 11/30/2022] Open
Affiliation(s)
- Masatomo Miura
- Department of Neurology; Graduate School of Medical Sciences; Kumamoto University; Kumamoto Japan
| | - Makoto Nakajima
- Department of Neurology; Graduate School of Medical Sciences; Kumamoto University; Kumamoto Japan
| | - Akiko Fujimoto
- Department of Neurology; Graduate School of Medical Sciences; Kumamoto University; Kumamoto Japan
| | - Shinya Shiraishi
- Department of Radiology; Graduate School of Medical Sciences; Kumamoto University; Kumamoto Japan
| | - David S. Liebeskind
- Department of Neurology; Neurovascular Imaging Research Core; University of California, Los Angeles; Los Angeles CA
| | - Yukio Ando
- Department of Neurology; Graduate School of Medical Sciences; Kumamoto University; Kumamoto Japan
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27
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Jones KM, Solnes LB, Rowe SP, Gorin MA, Sheikhbahaei S, Fung G, Frey EC, Allaf ME, Du Y, Javadi MS. Use of quantitative SPECT/CT reconstruction in 99mTc-sestamibi imaging of patients with renal masses. Ann Nucl Med 2017; 32:87-93. [PMID: 29214562 DOI: 10.1007/s12149-017-1222-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 11/26/2017] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Technetium-99m (99mTc)-sestamibi single-photon emission computed tomography/computed tomography (SPECT/CT) has previously been shown to allow for the accurate differentiation of benign renal oncocytomas and hybrid oncocytic/chromophobe tumors (HOCTs) apart from other malignant renal tumor histologies, with oncocytomas/HOCTs showing high uptake and renal cell carcinoma (RCC) showing low uptake based on uptake ratios from non-quantitative single-photon emission computed tomography (SPECT) reconstructions. However, in this study, several tumors fell close to the uptake ratio cutoff, likely due to limitations in conventional SPECT/CT reconstruction methods. We hypothesized that application of quantitative SPECT/CT (QSPECT) reconstruction methods developed by our group would provide more robust separation of hot and cold lesions, serving as an imaging framework on which quantitative biomarkers can be validated for evaluation of renal masses with 99mTc-sestamibi. METHODS Single-photon emission computed tomography data were reconstructed using the clinical Flash 3D reconstruction and QSPECT methods. Two blinded readers then characterized each tumor as hot or cold. Semi-quantitative uptake ratios were calculated by dividing lesion activity by background renal activity for both Flash 3D and QSPECT reconstructions. RESULTS The difference between median (mean) hot and cold tumor uptake ratios measured 0.655 (0.73) with the QSPECT method and 0.624 (0.67) with the conventional method, resulting in increased separation between hot and cold tumors. Sub-analysis of 7 lesions near the separation point showed a higher absolute difference (0.16) between QPSECT and Flash 3D mean uptake ratios compared to the remaining lesions. CONCLUSIONS Our finding of improved separation between uptake ratios of hot and cold lesions using QSPECT reconstruction lays the foundation for additional quantitative SPECT techniques such as SPECT-UV in the setting of renal 99mTc-sestamibi and other SPECT/CT exams. With robust quantitative image reconstruction and biomarker analysis, there may be an expanded role for SPECT/CT imaging in renal masses and other pathologic conditions.
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Affiliation(s)
- Krystyna M Jones
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N. Caroline St., Baltimore, MD, 21287, USA
| | - Lilja B Solnes
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N. Caroline St., Baltimore, MD, 21287, USA
| | - Steven P Rowe
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N. Caroline St., Baltimore, MD, 21287, USA.,The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Baltimore, MD, 21287, USA
| | - Michael A Gorin
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N. Caroline St., Baltimore, MD, 21287, USA.,The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Baltimore, MD, 21287, USA
| | - Sara Sheikhbahaei
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N. Caroline St., Baltimore, MD, 21287, USA
| | - George Fung
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N. Caroline St., Baltimore, MD, 21287, USA
| | - Eric C Frey
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N. Caroline St., Baltimore, MD, 21287, USA
| | - Mohamad E Allaf
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Baltimore, MD, 21287, USA
| | - Yong Du
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N. Caroline St., Baltimore, MD, 21287, USA
| | - Mehrbod S Javadi
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N. Caroline St., Baltimore, MD, 21287, USA
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28
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Kunieda T, Miyake K, Sakamoto H, Iwasaki Y, Iida S, Morise S, Fujita K, Nakamura M, Kaneko S, Kusaka H. Leptomeningeal Collaterals Strongly Correlate with Reduced Cerebrovascular Reactivity Measured by Acetazolamide-challenged Single-photon Emission Computed Tomography Using a Stereotactic Extraction Estimation Analysis in Patients with Unilateral Internal Carotid Artery Stenosis. Intern Med 2017; 56:2857-2863. [PMID: 28943539 PMCID: PMC5709627 DOI: 10.2169/internalmedicine.8397-16] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective To assess the correlation between the angiographic appearance of cerebral collateral pathways or the degree of internal carotid artery stenosis (ICAS) and reduced cerebrovascular reactivity (CVR) estimated by single-photon emission computed tomography (SPECT) image analysis in patients with unilateral ICAS. Methods A retrospective analysis was performed in 42 patients with unilateral ICAS who underwent cerebral angiography and acetazolamide-challenged SPECT of the brain. Cerebral blood flow quantitation was performed using the quantitative SPECT/dual-table autoradiography method. The CVR in the middle cerebral artery (MCA) territory was evaluated using the stereotactic extraction estimation based on the Japanese extracranial-intracranial bypass trial (SEE-JET) program and classified as reduced (<18.4%) or non-reduced (≥18.4%). Angiographic collateralization was classified as circle of Willis (type 1), extracranial-intracranial (type 2), and leptomeningeal (type 3). The degree of ICAS was defined as severe (≥70% stenosis) or non-severe (<70%). Results Eight patients showed reduced CVR, including 6 (46%) of 13 with type 3 collaterals and 2 (7%) of 29 without type 3 collaterals (p=0.006). In contrast, type 1 and type 2 collaterals and severe ICAS were not significantly associated with reduced CVR. Conclusion In patients with unilateral ICAS, leptomeningeal collaterals are strongly correlated with reduced CVR in the MCA territory, which presumably increases the risk of cerebral hyperperfusion after carotid artery stenting (CAS). Therefore, these findings may be clinically applicable to the perioperative management of CAS.
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Affiliation(s)
| | - Kosuke Miyake
- Department of Neurology, Kansai Medical University, Japan
| | | | - Yuko Iwasaki
- Department of Neurology, Kansai Medical University, Japan
| | - Shin Iida
- Department of Neurology, Kansai Medical University, Japan
| | - Satoshi Morise
- Department of Neurology, Kansai Medical University, Japan
| | - Kengo Fujita
- Department of Neurology, Kansai Medical University, Japan
| | | | - Satoshi Kaneko
- Department of Neurology, Kansai Medical University, Japan
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29
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Nakano A, Kawashima H, Miyake Y, Zeniya T, Yamamoto A, Koshino K, Temma T, Fukuda T, Fujita Y, Kakino A, Kanaya S, Sawamura T, Iida H. 123I-Labeled oxLDL Is Widely Distributed Throughout the Whole Body in Mice. Nucl Med Mol Imaging 2017; 52:144-153. [PMID: 29662563 DOI: 10.1007/s13139-017-0497-2] [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: 04/24/2017] [Revised: 09/13/2017] [Accepted: 09/13/2017] [Indexed: 01/14/2023] Open
Abstract
Purpose Oxidized low-density lipoprotein (oxLDL) plays a key role in endothelial dysfunction, vascular inflammation, and atherogenesis. The aim of this study was to assess blood clearance and in vivo kinetics of radiolabeled oxLDL in mice. Methods We synthesized 123I-oxLDL by the iodine monochloride method, and performed an uptake study in CHO cells transfected with lectin-like oxLDL receptor-1 (LOX-1). In addition, we evaluated the consistency between the 123I-oxLDL autoradiogram and the fluorescence image of DiI-oxLDL after intravenous injection for both spleen and liver. Whole-body dynamic planar images were acquired 10 min post injection of 123I-oxLDL to generate regional time-activity curves (TACs) of the liver, heart, lungs, kidney, head, and abdomen. Regional radioactivity for those excised tissues as well as the bladder, stomach, gut, and thyroid were assessed using a gamma counter, yielding percent injected dose (%ID) and dose uptake ratio (DUR). The presence of 123I-oxLDL in serum was assessed by radio-HPLC. Results The cellular uptakes of 123I-oxLDL were identical to those of DiI-oxLDL, and autoradiograms and fluorescence images also exhibited consistent distributions. TACs after injection of 123I-oxLDL demonstrated extremely fast kinetics. The radioactivity uptake at 10 min post-injection was highest in the liver (40.8 ± 2.4% ID). Notably, radioactivity uptake was equivalent throughout the rest of the body (39.4 ± 2.7% ID). HPLC analysis revealed no remaining 123I-oxLDL or its metabolites in the blood. Conclusion 123I-OxLDL was widely distributed not only in the liver, but also throughout the whole body, providing insight into the pathophysiological effects of oxLDL.
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Affiliation(s)
- Atushi Nakano
- 1Department of Investigative Radiology, National Cerebral and Cardiovascular Center Research Institute, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565 Japan.,2Department of Vascular Physiology, National Cerebral and Cardiovascular Center Research Institute, 5-7-1 Fujishiro-dai, Suita, Osaka, Japan
| | - Hidekazu Kawashima
- 1Department of Investigative Radiology, National Cerebral and Cardiovascular Center Research Institute, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565 Japan.,3Radioisotope Research Center, Kyoto Pharmaceutical University, 1 Misasagi-shichono-cho, Yamashina-ku, Kyoto, Japan
| | - Yoshinori Miyake
- 1Department of Investigative Radiology, National Cerebral and Cardiovascular Center Research Institute, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565 Japan
| | - Tsutomu Zeniya
- 1Department of Investigative Radiology, National Cerebral and Cardiovascular Center Research Institute, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565 Japan.,4Graduate School of Science and Technology, Hirosaki University, Bunkyo-cho, Hirosaki, Aomori, Japan
| | - Akihide Yamamoto
- 1Department of Investigative Radiology, National Cerebral and Cardiovascular Center Research Institute, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565 Japan
| | - Kazuhiro Koshino
- 1Department of Investigative Radiology, National Cerebral and Cardiovascular Center Research Institute, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565 Japan
| | - Takashi Temma
- 1Department of Investigative Radiology, National Cerebral and Cardiovascular Center Research Institute, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565 Japan.,5Department of Biofunctional Analysis, Osaka University of Pharmaceutical Sciences, 4-20-1 Nasahara, Takatsuki, Osaka, Japan
| | - Tetsuya Fukuda
- Department Radiology, National Cerebral and Cardiovacular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, Japan
| | - Yoshiko Fujita
- 7Department of Physiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, Japan
| | - Akemi Kakino
- 7Department of Physiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, Japan
| | - Shigehiko Kanaya
- Computational Systems Biology Laboratory, Graduate School of Information Science, Nara Institute of Science and Techonology, Takayama, Nara, Japan
| | - Tatsuya Sawamura
- 7Department of Physiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, Japan
| | - Hidehiro Iida
- 1Department of Investigative Radiology, National Cerebral and Cardiovascular Center Research Institute, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565 Japan.,Department Radiology, National Cerebral and Cardiovacular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, Japan.,Computational Systems Biology Laboratory, Graduate School of Information Science, Nara Institute of Science and Techonology, Takayama, Nara, Japan
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30
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Matsutomo N, Matsumoto S, Yamamoto T, Sato E. Validation of a calibration method using the cross-calibration factor and system planar sensitivity in quantitative single-photon emission computed tomography imaging. Radiol Phys Technol 2017; 10:439-445. [PMID: 28822095 DOI: 10.1007/s12194-017-0416-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 08/14/2017] [Accepted: 08/15/2017] [Indexed: 11/28/2022]
Abstract
The present study aimed to validate the absolute quantitative accuracy of a calibration method for single-photon emission computed tomography (SPECT) using cross-calibration factor (CCF)- and system sensitivity-based calibration methods. The CCF obtained with different reconstruction parameters was evaluated using a cylindrical phantom (diameter 20 cm, height 20 cm). SPECT images were acquired with a positron emission tomography/computed tomography (CT) phantom. Subsequently, they were reconstructed by using ordered subset expectation maximization with resolution recovery, scatter, and CT-based attenuation correction. All reconstructed SPECT counts were converted to activity concentrations based on the CCF and system planar sensitivity. We placed 12 circular regions of interest, 37 mm in diameter, on the phantom background, and the converted activity concentration and relative measurement error were assessed. The CCF obtained using a cylindrical phantom was affected by the iterative update number and post-smoothing filter function. The activity concentration calibrated using the CCF showed over- and underestimation. However, the activity concentration obtained from the system planar sensitivity was similar to that gained using the phantom. The values obtained using the system planar sensitivity were within 10% of the activity concentrations obtained with the phantom. These findings demonstrated that the calibration method using system planar sensitivity provides accurate quantification within 10% of the true activity concentration. Further clinical examination is required to validate the present results.
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Affiliation(s)
- Norikazu Matsutomo
- Department of Medical Radiological Technology, Faculty of Health Sciences, Kyorin University, 5-4-1 Shimorenjaku, Mitaka-shi, Tokyo, 181-8612, Japan.
| | - Saki Matsumoto
- Department of Radiology, Kyorin University Hospital, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Tomoaki Yamamoto
- Department of Medical Radiological Technology, Faculty of Health Sciences, Kyorin University, 5-4-1 Shimorenjaku, Mitaka-shi, Tokyo, 181-8612, Japan
| | - Eisuke Sato
- Department of Medical Radiological Technology, Faculty of Health Sciences, Kyorin University, 5-4-1 Shimorenjaku, Mitaka-shi, Tokyo, 181-8612, Japan
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Clinical Significance of Quantitative 123I-MIBG SPECT/CT Analysis of Pheochromocytoma and Paraganglioma. Clin Nucl Med 2017; 41:e465-e472. [PMID: 27607159 DOI: 10.1097/rlu.0000000000001334] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This retrospective study compared the diagnostic performances of quantitative versus visual analyses of I-MIBG scintigraphy in patients with suspected pheochromocytoma and paraganglioma (PPGL). MATERIALS AND METHODS SPECT images were obtained 6 and/or 24 h after MIBG injection from 68 patients with clinically suspected PPGL, with attenuation correction by low-dose unenhanced CT. Planar images were also obtained at each time point. SUVs of retroperitoneal tumors, including PPGLs, and physiological uptake by normal organs were measured using the SPECT images. The diagnostic performance of the quantitative assessment in differentiating PPGLs from other lesions or normal adrenal glands was assessed using receiver operating characteristic analysis. The planar scans and 6-h and 24-h SPECT/CT images were also assessed visually. RESULTS PPGLs showed a significantly higher SUVmax (mean ± SD = 9.97 ± 3.86) than other retroperitoneal lesions (3.85 ± 1.51) or normal adrenal glands (3.91 ± 1.20). At an optimal cut-off of 6.57, the sensitivity, specificity, and accuracy of the quantitative assessment for 6-h SPECT/CT in differentiating PPGLs was 78.6%, 96.3%, and 92.6%, respectively; the area under the curve was 0.878. The diagnostic performance did not significantly differ between the quantitative and visual analyses, but the specificity of the former tended to be higher at 6 h (96.3% vs. 90.7%) and at 24 h (91.2% vs. 82.4%). CONCLUSIONS The specificity, but not the sensitivity, of the quantitative approach was higher than that of visual assessment in differentiating PPGLs from other retroperitoneal pathologies and from physiological uptake in the normal adrenal gland.
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Choi JW, Kim MH, Park SA, Sin DS, Kim MS. Neural Correlates of Motor Recovery Measured by SPECT at Six Months After Basal Ganglia Stroke. Ann Rehabil Med 2017; 41:905-914. [PMID: 29354566 PMCID: PMC5773433 DOI: 10.5535/arm.2017.41.6.905] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 05/22/2017] [Indexed: 11/05/2022] Open
Affiliation(s)
- Ji Won Choi
- Department of Rehabilitation Medicine, Wonkwang University School of Medicine and Hospital, Iksan, Korea
| | - Myoung Hyoun Kim
- Department of Nuclear Medicine, Wonkwang University School of Medicine and Hospital, Iksan, Korea
| | - Soon-Ah Park
- Department of Nuclear Medicine, Wonkwang University School of Medicine and Hospital, Iksan, Korea
| | - Deok Su Sin
- Department of Rehabilitation Medicine, Wonkwang University School of Medicine and Hospital, Iksan, Korea
| | - Min-Su Kim
- Department of Rehabilitation Medicine, Wonkwang University School of Medicine and Hospital, Iksan, Korea
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Kimura H, Taniguchi M, Mori T, Hosoda K, Kohmura E. Clinical Implication of Temporary Hypointense Lesion on Diffusion-Weighted Imaging After Extracranial–Intracranial Bypass Surgery. World Neurosurg 2017; 97:754.e17-754.e21. [DOI: 10.1016/j.wneu.2016.10.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 09/30/2016] [Accepted: 10/04/2016] [Indexed: 11/27/2022]
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Abstract
The synergy of functional and anatomic information in hybrid systems has undoubtedly enhanced the diagnostic potential of radionuclide imaging in recent years, contributing to the advancement of SPECT/CT in clinical practice. Since the introduction of commercial SPECT/CT in the late 1990 s, the field has seen rapid expansion and development toward multidetector CT subsystems, establishing the role of SPECT/CT as a routine imaging tool. It is, however, important to discuss possible challenges and technical limitations of such systems and how these influence imaging outcomes. In particular, the issues of patient motion and spatial misalignment of the SPECT and CT modalities, data corrections such as those for photon attenuation, and the choice of CT acquisition protocols in relation to radiation exposure are discussed in the article.
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Affiliation(s)
- Lefteris Livieratos
- Nuclear Medicine Department, Guy's & St Thomas' Hospitals, London, UK; Imaging Sciences and Biomedical Engineering, King's College London, London, UK.
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35
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Hara T, Ishihara T, Asano T, Matsuo M, Katafuchi T, Fujita H. A robust conversion method of radioactivities between plastic and NaI scintillation well counters for long-term quality control and quality assurance. EJNMMI Phys 2016; 3:18. [PMID: 27526050 PMCID: PMC4998199 DOI: 10.1186/s40658-016-0154-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 07/14/2016] [Indexed: 11/17/2022] Open
Abstract
Purpose The purpose of this study is to specify a simple procedure for a
robust data conversion of radioactivity value between plastic scintillator (PL)
and NaI scintillator (NaI) devices. Materials and methods The radioactivity estimate of 100 blood samples was measured by the
two devices. The two radioactivities were plotted on the same graph. The
least-squares method was applied to obtain the conversion function. The
differences between the actual radioradioy (N)
from the NaI device and the estimated radioactivity for NaI (N’) from the PL device activity (P) were statistically analyzed. Results N’ was determined from P as N’ = 4.45 P + 6.28 with high correlation (r = 0.997). The Bland-Altman analysis between N’ and N showed no
fixed bias and no proportional bias. Conclusions A hundred blood samples using a fixed type of sample tubes and a
fixed radionuclide may be required to set up the robust conversion
function.
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Affiliation(s)
- Takeshi Hara
- Department of Intelligent Image Information, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan.
| | - Tadahiko Ishihara
- Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Takahiko Asano
- Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Masayuki Matsuo
- Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Tetsuro Katafuchi
- School of Health Science, Gifu University of Medical Science, 795-1 Ichihiraga, Nagamine, Seki, Gifu, 501-3892, Japan
| | - Hiroshi Fujita
- Department of Intelligent Image Information, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
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Multicenter evaluation of single-photon emission computed tomography quantification with third-party reconstruction software. Nucl Med Commun 2016; 37:983-7. [PMID: 27128824 DOI: 10.1097/mnm.0000000000000538] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Reliable and reproducible quantification is essential in many clinical situations. Previously, single-photon emission computed tomography (SPECT) has not been considered a quantitative imaging modality, but recent advances in reconstruction algorithm development have made SPECT quantitative. In this study, we investigate the reproducibility of SPECT quantification with phantoms in a multicenter setting using novel third-party reconstruction software. A total of five hospitals and eight scanners (three GE scanners and five Siemens scanners) participated in the study. A Jaszczak phantom without inserts was used to calculate counts to activity concentration conversion factors. The quantitative accuracy was tested using the NEMA-IEC phantom with six spherical inserts (diameters from 10 to 37 mm) filled to an 8 : 1 insert-background concentration ratio. Phantom studies were reconstructed at one central location using HERMES HybridRecon applying corrections for attenuation, collimator-detector response, and scatter. Spherical volumes of interest with the same diameter as the inserts were drawn on the images and recovery coefficients for the spheres were calculated. The coefficient of variation (CoV) of the NEMA-IEC phantom recovery coefficients ranged from ∼19 to 5% depending on the insert diameter so that the lowest CoV was obtained with the largest spheres. The intersite CoV was almost equal to intrasite CoV. In conclusion, quantitative SPECT is reproducible in a multicenter setting with third-party reconstruction software.
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37
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Zimmerman BE, Grošev D, Buvat I, Coca Pérez MA, Frey EC, Green A, Krisanachinda A, Lassmann M, Ljungberg M, Pozzo L, Quadir KA, Terán Gretter MA, Van Staden J, Poli GL. Multi-centre evaluation of accuracy and reproducibility of planar and SPECT image quantification: An IAEA phantom study. Z Med Phys 2016; 27:98-112. [PMID: 27105765 DOI: 10.1016/j.zemedi.2016.03.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 03/07/2016] [Accepted: 03/30/2016] [Indexed: 10/21/2022]
Abstract
Accurate quantitation of activity provides the basis for internal dosimetry of targeted radionuclide therapies. This study investigated quantitative imaging capabilities at sites with a variety of experience and equipment and assessed levels of errors in activity quantitation in Single-Photon Emission Computed Tomography (SPECT) and planar imaging. Participants from 9 countries took part in a comparison in which planar, SPECT and SPECT with X ray computed tomography (SPECT-CT) imaging were used to quantify activities of four epoxy-filled cylinders containing 133Ba, which was chosen as a surrogate for 131I. The sources, with nominal volumes of 2, 4, 6 and 23mL, were calibrated for 133Ba activity by the National Institute of Standards and Technology, but the activity was initially unknown to the participants. Imaging was performed in a cylindrical phantom filled with water. Two trials were carried out in which the participants first estimated the activities using their local standard protocols, and then repeated the measurements using a standardized acquisition and analysis protocol. Finally, processing of the imaging data from the second trial was repeated by a single centre using a fixed protocol. In the first trial, the activities were underestimated by about 15% with planar imaging. SPECT with Chang's first order attenuation correction (Chang-AC) and SPECT-CT overestimated the activity by about 10%. The second trial showed moderate improvements in accuracy and variability. Planar imaging was subject to methodological errors, e.g., in the use of a transmission scan for attenuation correction. The use of Chang-AC was subject to variability from the definition of phantom contours. The project demonstrated the need for training and standardized protocols to achieve good levels of quantitative accuracy and precision in a multicentre setting. Absolute quantification of simple objects with no background was possible with the strictest protocol to about 6% with planar imaging and SPECT (with Chang-AC) and within 2% for SPECT-CT.
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Affiliation(s)
- Brian E Zimmerman
- National Institute of Standards and Technology, Gaithersburg, MD, USA.
| | - Darko Grošev
- University Hospital Centre Zagreb, Zagreb, Croatia
| | - Irène Buvat
- Service Hospitalier Frédéric Joliot, Paris, France
| | | | | | - Alan Green
- National Physical Laboratory, Teddington, UK
| | | | | | | | - Lorena Pozzo
- Institute of Energy and Nuclear Research, São Paulo, Brazil
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Buchert R, Kluge A, Tossici-Bolt L, Dickson J, Bronzel M, Lange C, Asenbaum S, Booij J, Atay Kapucu LÖ, Svarer C, Koulibaly PM, Nobili F, Pagani M, Sabri O, Sera T, Tatsch K, Vander Borght T, Van Laere K, Varrone A, Iida H. Reduction in camera-specific variability in [123I]FP-CIT SPECT outcome measures by image reconstruction optimized for multisite settings: impact on age-dependence of the specific binding ratio in the ENC-DAT database of healthy controls. Eur J Nucl Med Mol Imaging 2016; 43:1323-36. [DOI: 10.1007/s00259-016-3309-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 01/05/2016] [Indexed: 10/22/2022]
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39
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Zhang H, Fujiwara N, Kobayashi M, Yamada S, Liang F, Takagi S, Oshima M. Development of a Numerical Method for Patient-Specific Cerebral Circulation Using 1D-0D Simulation of the Entire Cardiovascular System with SPECT Data. Ann Biomed Eng 2015; 44:2351-2363. [PMID: 26721836 DOI: 10.1007/s10439-015-1544-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 12/22/2015] [Indexed: 11/28/2022]
Abstract
The detailed flow information in the circle of Willis (CoW) can facilitate a better understanding of disease progression, and provide useful references for disease treatment. We have been developing a one-dimensional-zero-dimensional (1D-0D) simulation method for the entire cardiovascular system to obtain hemodynamics information in the CoW. This paper presents a new method for applying 1D-0D simulation to an individual patient using patient-specific data. The key issue is how to adjust the deviation of physiological parameters, such as peripheral resistance, from literature data when patient-specific geometry is used. In order to overcome this problem, we utilized flow information from single photon emission computed tomography (SPECT) data. A numerical method was developed to optimize physiological parameters by adjusting peripheral cerebral resistance to minimize the difference between the resulting flow rate and the SPECT data in the efferent arteries of the CoW. The method was applied to three cases using different sets of patient-specific data in order to investigate the hemodynamics of the CoW. The resulting flow rates in the afferent arteries were compared to those of the phase-contrast magnetic resonance angiography (PC-MRA) data. Utilization of the SPECT data combined with the PC-MRA data showed a good agreement in flow rates in the afferent arteries of the CoW with those of PC-MRA data for all three cases. The results also demonstrated that application of SPECT data alone could provide the information on the ratios of flow distributions among arteries in the CoW.
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Affiliation(s)
- Hao Zhang
- Department of Mechanical Engineering, The University of Tokyo, Tokyo, Japan.
| | - Naoya Fujiwara
- Center for Spatial Information Science, The University of Tokyo, Chiba, Japan
| | - Masaharu Kobayashi
- Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan
| | - Shigeki Yamada
- Department of Neurosurgey, Stroke Center, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Fuyou Liang
- Department of Naval Architecture and Ocean Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Shu Takagi
- Department of Mechanical Engineering, The University of Tokyo, Tokyo, Japan
| | - Marie Oshima
- Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan
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40
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Di Cesare Mannelli L, Micheli L, Carta F, Cozzi A, Ghelardini C, Supuran CT. Carbonic anhydrase inhibition for the management of cerebral ischemia: in vivo evaluation of sulfonamide and coumarin inhibitors. J Enzyme Inhib Med Chem 2015; 31:894-9. [DOI: 10.3109/14756366.2015.1113407] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Lorenzo Di Cesare Mannelli
- Dipartimento di Neuroscienze, Psicologia, Area del Farmaco e Salute del Bambino - NEUROFARBA - Sezione di Farmacologia e Tossicologia, Università degli Studi di Firenze, Florence, Italy,
| | - Laura Micheli
- Dipartimento di Neuroscienze, Psicologia, Area del Farmaco e Salute del Bambino - NEUROFARBA - Sezione di Farmacologia e Tossicologia, Università degli Studi di Firenze, Florence, Italy,
| | - Fabrizio Carta
- Dipartimento Di Chimica, Laboratorio Di Chimica Bioinorganica, Università Degli Studi Di Firenze, Sesto Fiorentino, Florence, Italy,
| | - Andrea Cozzi
- Dipartimento di Medicina Clinica e Sperimentale - DMSC - Università degli Studi di Firenze, Florence, Italy, and
| | - Carla Ghelardini
- Dipartimento di Neuroscienze, Psicologia, Area del Farmaco e Salute del Bambino - NEUROFARBA - Sezione di Farmacologia e Tossicologia, Università degli Studi di Firenze, Florence, Italy,
| | - Claudiu T. Supuran
- Dipartimento Di Chimica, Laboratorio Di Chimica Bioinorganica, Università Degli Studi Di Firenze, Sesto Fiorentino, Florence, Italy,
- Dipartimento Neurofarba, Sezione Di Scienze Farmaceutiche, Polo Scientifico, Università Degli Studi Di Firenze, Sesto Fiorentino, Florence, Italy
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41
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Bailey DL, Hennessy TM, Willowson KP, Henry EC, Chan DLH, Aslani A, Roach PJ. In vivo quantification of (177)Lu with planar whole-body and SPECT/CT gamma camera imaging. EJNMMI Phys 2015; 2:20. [PMID: 26501821 PMCID: PMC4573647 DOI: 10.1186/s40658-015-0123-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 08/25/2015] [Indexed: 11/24/2022] Open
Abstract
Background Advances in gamma camera technology and the emergence of a number of new theranostic radiopharmaceutical pairings have re-awakened interest in in vivo quantification with single-photon-emitting radionuclides. We have implemented and validated methodology to provide quantitative imaging of 177Lu for 2D whole-body planar studies and for 3D tomographic imaging with single-photon emission computed tomography (SPECT)/CT. Methods Whole-body planar scans were performed on subjects to whom a known amount of [177Lu]-DOTA-octreotate had been administered for therapy. The total radioactivity estimated from the images was compared with the known amount of the radionuclide therapy administered. In separate studies, venous blood samples were withdrawn from subjects after administration of [177Lu]-DOTA-octreotate while a SPECT acquisition was in progress and the concentration of the radionuclide in the venous blood sample compared with that estimated from large blood pool structures in the SPECT reconstruction. The total radioactivity contained within an internal SPECT calibration standard was also assessed. Results In the whole-body planar scans (n = 28), the estimated total body radioactivity was accurate to within +4.6 ± 5.9 % (range −17.1 to +11.2 %) of the correct value. In the SPECT reconstructions (n = 12), the radioactivity concentration in the cardiac blood pool was accurate to within −4.0 ± 7.8 % (range −16.1 to +7.5 %) of the true value and the internal standard measurements (n = 89) were within 2.0 ± 8.5 % (range −16.3 to +24.2 %) of the known amount of radioactivity contained. Conclusions In our hands, state-of-the-art hybrid SPECT/CT gamma cameras were able to provide accurate estimates of in vivo radioactivity to better than, on average, ±10 % for use in biodistribution and radionuclide dosimetry calculations.
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Affiliation(s)
- Dale L Bailey
- Department of Nuclear Medicine, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia. .,Faculty of Health Sciences, University of Sydney, Cumberland, NSW, Australia. .,Sydney Medical School, University of Sydney, Camperdown, NSW, Australia. .,NETwork, Sydney Vital, St Leonards, Sydney, NSW, Australia.
| | - Thomas M Hennessy
- Institute of Medical Physics, University of Sydney, Camperdown, NSW, Australia
| | - Kathy P Willowson
- Institute of Medical Physics, University of Sydney, Camperdown, NSW, Australia
| | - E Courtney Henry
- Institute of Medical Physics, University of Sydney, Camperdown, NSW, Australia
| | - David L H Chan
- Department of Nuclear Medicine, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia.,NETwork, Sydney Vital, St Leonards, Sydney, NSW, Australia
| | - Alireza Aslani
- Department of Nuclear Medicine, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - Paul J Roach
- Department of Nuclear Medicine, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia.,Sydney Medical School, University of Sydney, Camperdown, NSW, Australia
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Kanemaru K, Kinouchi H, Yoshioka H, Yagi T, Wakai T, Hashimoto K, Fukumoto Y, Umeda T, Onishi H, Nishiyama Y, Horikoshi T. Cerebral hemodynamic disturbance in dural arteriovenous fistula with retrograde leptomeningeal venous drainage: a prospective study using 123I-iodoamphetamine single photon emission computed tomography. J Neurosurg 2015; 123:110-7. [DOI: 10.3171/2014.10.jns141576] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT
The severity of cerebral hemodynamic disturbance caused by retrograde leptomeningeal venous drainage (RLVD) of a dural arteriovenous fistula (dAVF) is related to neurological morbidity and unfavorable outcome. However, the cerebral hemodynamics of this disorder have not been elucidated well. The aim of this study was to assess the relationship between the cerebral venous congestive encephalopathy represented as a high-intensity area (HIA) on T2-weighted MR images and the cerebral hemodynamics examined by 123I-iodoamphetamine (IMP) single photon emission computed tomography (SPECT), as well as the predictive value of 123I-IMP SPECT for the development and reversibility of venous congestion encephalopathy.
METHODS
Based on the pre- and posttreatment T2 HIAs associated with venous congestion encephalopathy, patients were divided into 3 groups: a normal group, an edema group, and an infarction group. The regional cerebral blood flow (rCBF) at the region with RLVD was analyzed by 123I-IMP SPECT, and the results were compared among the groups.
RESULTS
There were 11, 6, and 3 patients in the normal, edema, and infarction groups, respectively. No patients in the normal group showed any symptoms related to venous congestion. In contrast, all patients in the edema and infarction groups developed neurological symptoms. The rCBF in the edema group was significantly lower than that in the normal group, and significantly higher than that in the infarction group. The cerebral vascular reactivity (CVR) of the infarction group was significantly lower than that of the normal and edema groups. After treatment, the neurological signs disappeared in the edema group, but only partial improvement was seen in the infarction group. The rCBF also significantly increased in the normal and edema groups, but not in the infarction group.
CONCLUSIONS
Quantitative rCBF measurement is useful for evaluating hemodynamic disturbance in dAVF with RLVD. The reduction of rCBF was strongly correlated with the severity of venous congestive encephalopathy, and loss of CVR is a reliable indicator of irreversible venous infarction caused by RLVD.
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Affiliation(s)
| | | | | | | | | | | | | | - Takako Umeda
- 2Radiology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Hiroshi Onishi
- 2Radiology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Yamanashi, Japan
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Takagi Y, Miyamoto S. Cognitive Dysfunction Survey of the Japanese Patients with Moyamoya Disease (COSMO-JAPAN Study): study protocol. Neurol Med Chir (Tokyo) 2015; 55:199-203. [PMID: 25739435 PMCID: PMC4533331 DOI: 10.2176/nmc.ra.2014-0326] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Moyamoya disease is a cerebrovascular occlusive disease characterized by progressive stenosis or by occlusion at the terminal portion of the bilateral internal carotid arteries. The unusual vascular network (moyamoya vessels) at the base of the brain with this disease as collateral channels is developed in this disease. Social independence because of cognitive impairment has recently been recognized as an important unsolved social issue with adult moyamoya disease. The patients with cognitive impairment have difficulty in proving their status because the standard neuroradiological and neuropsychological methods to define cognitive impairment with moyamoya disease are not determined. These patients with cognitive impairment should be supported by social welfare as psychologically handicapped persons. Thus Cognitive Dysfunction Survey of the Japanese Patients with Moyamoya Disease (COSMO-JAPAN study) is planned. In this study, we want to establish a standard finding of the cognitive impairment in patients with moyamoya disease.
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Affiliation(s)
- Yasushi Takagi
- Department of Neurosurgery, Kyoto University Graduate School of Medicine
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44
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Kashiwazaki D, Akioka N, Kuwayama N, Noguchi K, Tanaka K, Kuroda S. Pathophysiology of Acute Cerebrovascular Syndrome in Patients With Carotid Artery Stenosis. Neurosurgery 2015; 76:427-33; discussion 433-4. [DOI: 10.1227/neu.0000000000000655] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Abstract
BACKGROUND:
The mechanisms underlying acute cerebrovascular syndrome in patients with carotid artery stenosis remain unclear.
OBJECTIVE:
To assess the relationships among infarct localization, hemodynamics, and plaque components.
METHODS:
This prospective study included 38 patients with acute cerebrovascular syndrome resulting from ipsilateral carotid artery stenosis. Cerebral infarct localization was categorized into 3 patterns (cortical, border zone, and mixed pattern). Carotid plaque components were evaluated with T1-weighted magnetic resonance imaging and time-of-flight imaging. Cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) were also quantified.
RESULTS:
Infarcts were identified in 38 patients with the use of diffusion-weighted magnetic resonance imaging. On the basis of the assessment of hemodynamics, the cortical pattern was seen in 18 of 21 patients with type 1 ischemia (normal CBF, normal CVR), whereas the mixed pattern was seen in 2 patients with type 2 ischemia (normal CBF, impaired CVR) and 12 of 15 patients with type 3 ischemia (impaired CBF, impaired CVR). The plaque components were categorized into fibrous (4 patients), lipid-rich (14 patients), and intraplaque hemorrhage (IPH; 20 patients). Of the patients with fibrous plaque, 2 had border-zone and 2 had mixed-pattern infarcts. Of the patients with lipid-rich plaque, 7 had cortical and 6 had mixed-pattern infarcts. Of patients with intraplaque hemorrhage, 11 had cortical and 9 had mixed-pattern infarcts.
CONCLUSION:
Cortical infarction occurs as a result of vulnerable plaque. Reduced cerebral perfusion induces border-zone infarction. Both factors are implicated in mixed-pattern infarction. Developments in noninvasive diagnostic modalities allow us to explore the mechanisms behind acute cerebrovascular syndrome in carotid artery stenosis and to determine the ideal therapies.
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Affiliation(s)
| | | | | | - Kyo Noguchi
- Radiology, Graduate School of Medicine and Pharmacological Science, University of Toyama, Toyama, Japan
| | - Kortaro Tanaka
- Department of Neurology, Toyama University Hospital, Toyama, Japan
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45
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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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Hori Y, Hirano Y, Koshino K, Moriguchi T, Iguchi S, Yamamoto A, Enmi J, Kawashima H, Zeniya T, Morita N, Nakagawara J, Casey ME, Iida H. Validity of using a 3-dimensional PET scanner during inhalation of 15O-labeled oxygen for quantitative assessment of regional metabolic rate of oxygen in man. Phys Med Biol 2014; 59:5593-609. [PMID: 25179552 DOI: 10.1088/0031-9155/59/18/5593] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Use of 15O labeled oxygen (15O2) and positron emission tomography (PET) allows quantitative assessment of the regional metabolic rate of oxygen (CMRO2) in vivo, which is essential to understanding the pathological status of patients with cerebral vascular and neurological disorders. The method has, however, been challenging, when a 3D PET scanner is employed, largely attributed to the presence of gaseous radioactivity in the trachea and the inhalation system, which results in a large amount of scatter and random events in the PET assessment. The present study was intended to evaluate the adequacy of using a recently available commercial 3D PET scanner in the assessment of regional cerebral radioactivity distribution during an inhalation of 15O2. Systematic experiments were carried out on a brain phantom. Experiments were also performed on a healthy volunteer following a recently developed protocol for simultaneous assessment of CMRO2 and cerebral blood flow, which involves sequential administration of 15O2 and C15O2. A particular intention was to evaluate the adequacy of the scatter-correction procedures. The phantom experiment demonstrated that errors were within 3% at the practically maximum radioactivity in the face mask, with the greatest radioactivity in the lung. The volunteer experiment demonstrated that the counting rate was at peak during the 15O gas inhalation period, within a verified range. Tomographic images represented good quality over the entire FOV, including the lower part of the cerebral structures and the carotid artery regions. The scatter-correction procedures appeared to be important, particularly in the process to compensate for the scatter originating outside the FOV. Reconstructed images dramatically changed if the correction was carried out using inappropriate procedures. This study demonstrated that accurate reconstruction could be obtained when the scatter compensation was appropriately carried out. This study also suggested the feasibility of using a state-of-the-art 3D PET scanner in the quantitative PET imaging during inhalation of 15O labeled oxygen.
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Affiliation(s)
- Yuki Hori
- Department of Investigative Radiology, National Cerebral and Cardiovascular Center Research Institute, Suita City, Osaka, Japan
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Kenda S, Onishi H, Nakamoto K. Optimization of reconstruction parameters using a multi-focus fan beam collimator in myocardial perfusion single photon emission computed tomography study. Nihon Hoshasen Gijutsu Gakkai Zasshi 2014; 70:662-9. [PMID: 25055946 DOI: 10.6009/jjrt.2014_jsrt_70.7.662] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE The aim of this study was to optimize the reconstruction parameters for ordered subset conjugate gradient minimization (OSCGM) reconstruction using a multifocus fan beam collimator in myocardial perfusion single photon emission computed tomography (SPECT). METHOD We attempted to validate the following performance of OSCGM reconstruction parameters (iteration and subset). SPECT images were acquired using a dual-head gamma camera with IQ mode acquisition systems from a RH-2 cardiac phantom containing a 99m-Tc solution. The performance was evaluated using reconstruction parameters (product of subset and iteration: SI) with image contrast, LV volume [using quantitative perfusion SPECT (QPS)], root mean square uncertainty (RMSU), and normalized mean squared error (NMSE). RESULTS The best results (contrast, uniformity, LV volume, and NMSE) were found for SI: 30. LV volume indicated the true volume for subset: 1 and iteration: 30, and LV volume was underestimated by 10% for iteration >20, and subset >1. CONCLUSION The results of this myocardial perfusion SPECT study suggest the optimal OSCGM reconstruction parameter to be subset: 1 and iteration: 30 using a multifocus fan beam collimator.
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Affiliation(s)
- Shuji Kenda
- Program in Health and Welfare, Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima
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Cognitive dysfunction might be improved in association with recovered neuronal viability after intracranial meningioma resection. Brain Res 2014; 1574:50-9. [DOI: 10.1016/j.brainres.2014.05.047] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 02/27/2014] [Accepted: 05/30/2014] [Indexed: 11/20/2022]
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50
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Oka F, Ishihara H, Kato S, Oku T, Yamane A, Kunitugu I, Suzuki M. Cerebral hemodynamic benefits after carotid artery stenting in patients with near occlusion. J Vasc Surg 2013; 58:1512-7. [DOI: 10.1016/j.jvs.2013.05.103] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Revised: 05/21/2013] [Accepted: 05/21/2013] [Indexed: 10/26/2022]
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