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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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Petr J, Hogeboom L, Nikulin P, Wiegers E, Schroyen G, Kallehauge J, Chmelík M, Clement P, Nechifor RE, Fodor LA, De Witt Hamer PC, Barkhof F, Pernet C, Lequin M, Deprez S, Jančálek R, Mutsaerts HJMM, Pizzini FB, Emblem KE, Keil VC. A systematic review on the use of quantitative imaging to detect cancer therapy adverse effects in normal-appearing brain tissue. MAGMA (NEW YORK, N.Y.) 2022; 35:163-186. [PMID: 34919195 PMCID: PMC8901489 DOI: 10.1007/s10334-021-00985-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/09/2021] [Accepted: 12/03/2021] [Indexed: 12/17/2022]
Abstract
Cancer therapy for both central nervous system (CNS) and non-CNS tumors has been previously associated with transient and long-term cognitive deterioration, commonly referred to as 'chemo fog'. This therapy-related damage to otherwise normal-appearing brain tissue is reported using post-mortem neuropathological analysis. Although the literature on monitoring therapy effects on structural magnetic resonance imaging (MRI) is well established, such macroscopic structural changes appear relatively late and irreversible. Early quantitative MRI biomarkers of therapy-induced damage would potentially permit taking these treatment side effects into account, paving the way towards a more personalized treatment planning.This systematic review (PROSPERO number 224196) provides an overview of quantitative tomographic imaging methods, potentially identifying the adverse side effects of cancer therapy in normal-appearing brain tissue. Seventy studies were obtained from the MEDLINE and Web of Science databases. Studies reporting changes in normal-appearing brain tissue using MRI, PET, or SPECT quantitative biomarkers, related to radio-, chemo-, immuno-, or hormone therapy for any kind of solid, cystic, or liquid tumor were included. The main findings of the reviewed studies were summarized, providing also the risk of bias of each study assessed using a modified QUADAS-2 tool. For each imaging method, this review provides the methodological background, and the benefits and shortcomings of each method from the imaging perspective. Finally, a set of recommendations is proposed to support future research.
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Affiliation(s)
- Jan Petr
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany.
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam Neuroscience, Amsterdam, The Netherlands.
| | - Louise Hogeboom
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Pavel Nikulin
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Evita Wiegers
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gwen Schroyen
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Jesper Kallehauge
- Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Marek Chmelík
- Department of Technical Disciplines in Medicine, Faculty of Health Care, University of Prešov, Prešov, Slovakia
| | - Patricia Clement
- Ghent Institute for Functional and Metabolic Imaging (GIfMI), Ghent University, Ghent, Belgium
| | - Ruben E Nechifor
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Department of Clinical Psychology and Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Liviu-Andrei Fodor
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Evidence Based Psychological Assessment and Interventions Doctoral School, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Philip C De Witt Hamer
- Department of Neurosurgery, Amsterdam UMC, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam Neuroscience, Amsterdam, The Netherlands
- UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Cyril Pernet
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Maarten Lequin
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sabine Deprez
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Radim Jančálek
- St. Anne's University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Henk J M M Mutsaerts
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Ghent Institute for Functional and Metabolic Imaging (GIfMI), Ghent University, Ghent, Belgium
| | - Francesca B Pizzini
- Radiology, Deptartment of Diagnostic and Public Health, Verona University, Verona, Italy
| | - Kyrre E Emblem
- Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Vera C Keil
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam Neuroscience, Amsterdam, The Netherlands
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Hipskind SG, Grover FL, Fort TR, Helffenstein D, Burke TJ, Quint SA, Bussiere G, Stone M, Hurtado T. Pulsed Transcranial Red/Near-Infrared Light Therapy Using Light-Emitting Diodes Improves Cerebral Blood Flow and Cognitive Function in Veterans with Chronic Traumatic Brain Injury: A Case Series. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2020; 37:77-84. [PMID: 31050928 PMCID: PMC6390875 DOI: 10.1089/photob.2018.4489] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Objective: This study explored the outcome of applying red/near-infrared light therapy using light-emitting diodes (LEDs) pulsed with three different frequencies transcranially to treat traumatic brain injury (TBI) in Veterans. Background: Photobiomodulation therapy (PBMT) using LEDs has been shown to have positive effects on TBI in humans and animal models. Materials and methods: Twelve symptomatic military Veterans diagnosed with chronic TBI >18 months post-trauma received pulsed transcranial PBMT (tPBMT) using two neoprene therapy pads containing 220 infrared and 180 red LEDs, generating a power output of 3.3 W and an average power density of 6.4 mW/cm2 for 20 min, thrice per week over 6 weeks. Outcome measures included standardized neuropsychological test scores and qualitative and quantitative single photon emission computed tomography (SPECT) measures of regional cerebral blood flow (rCBF). Results: Pulsed tPBMT significantly improved neuropsychological scores in 6 of 15 subscales (40.0%; p < 0.05; two tailed). SPECT analysis showed increase in rCBF in 8 of 12 (66.7%) study participants. Quantitative SPECT analysis revealed a significant increase in rCBF in this subgroup of study participants and a significant difference between pre-treatment and post-treatment gamma ray counts per cubic centimeter [t = 3.77, df = 7, p = 0.007, 95% confidence interval (95,543.21–21,931.82)]. This is the first study to report quantitative SPECT analysis of rCBF in regions of interest following pulsed tPBMT with LEDs in TBI. Conclusions: Pulsed tPBMT using LEDs shows promise in improving cognitive function and rCBF several years after TBI. Larger, controlled studies are indicated.
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Affiliation(s)
- S Gregory Hipskind
- 1 Brain Injury Consulting, LLC, Department of Brain Research, Addison, Texas.,2 InLight Medical, Medical Advisory Department, Addison, Texas
| | - Fred L Grover
- 3 Revolutionary MD, Department of Medical Research, Denver, Colorado
| | - T Richard Fort
- 4 CereScan Corporation, Department of Imaging Research, Littleton, Colorado
| | - Dennis Helffenstein
- 5 Colorado Neuropsychological Associates, Testing Department, Englewood, Colorado
| | - Thomas J Burke
- 6 University of Colorado School of Medicine, Department of Physiology (Retired), Aurora, Colorado
| | - Shane A Quint
- 4 CereScan Corporation, Department of Imaging Research, Littleton, Colorado
| | - Garrett Bussiere
- 4 CereScan Corporation, Department of Imaging Research, Littleton, Colorado
| | - Michael Stone
- 7 Veterans Administration Hospital, Department of Radiology, Las Vegas, Nevada
| | - Timothy Hurtado
- 8 Penrose-St. Francis Health Services, Emergency Department, Colorado Springs, Colorado
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4
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Hipskind SG, Grover FL, Fort TR, Helffenstein D, Burke TJ, Quint SA, Bussiere G, Stone M, Hurtado T. Pulsed Transcranial Red/Near-Infrared Light Therapy Using Light-Emitting Diodes Improves Cerebral Blood Flow and Cognitive Function in Veterans with Chronic Traumatic Brain Injury: A Case Series. Photomed Laser Surg 2018:pho.2018.4489. [PMID: 30418082 DOI: 10.1089/pho.2018.4489] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE This study explored the outcome of applying red/near-infrared light therapy using light-emitting diodes (LEDs) pulsed with three different frequencies transcranially to treat traumatic brain injury (TBI) in Veterans. BACKGROUND Photobiomodulation therapy (PBMT) using LEDs has been shown to have positive effects on TBI in humans and animal models. MATERIALS AND METHODS Twelve symptomatic military Veterans diagnosed with chronic TBI >18 months post-trauma received pulsed transcranial PBMT (tPBMT) using two neoprene therapy pads containing 220 infrared and 180 red LEDs, generating a power output of 3.3 W and an average power density of 6.4 mW/cm2 for 20 min, thrice per week over 6 weeks. Outcome measures included standardized neuropsychological test scores and qualitative and quantitative single photon emission computed tomography (SPECT) measures of regional cerebral blood flow (rCBF). RESULTS Pulsed tPBMT significantly improved neuropsychological scores in 6 of 15 subscales (40.0%; p < 0.05; two tailed). SPECT analysis showed increase in rCBF in 8 of 12 (66.7%) study participants. Quantitative SPECT analysis revealed a significant increase in rCBF in this subgroup of study participants and a significant difference between pre-treatment and post-treatment gamma ray counts per cubic centimeter [t = 3.77, df = 7, p = 0.007, 95% confidence interval (95,543.21-21,931.82)]. This is the first study to report quantitative SPECT analysis of rCBF in regions of interest following pulsed tPBMT with LEDs in TBI. CONCLUSIONS Pulsed tPBMT using LEDs shows promise in improving cognitive function and rCBF several years after TBI. Larger, controlled studies are indicated.
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Affiliation(s)
- S Gregory Hipskind
- 1 Brain Injury Consulting, LLC , Department of Brain Research, Addison, Texas
- 2 InLight Medical , Medical Advisory Department, Addison, Texas
| | - Fred L Grover
- 3 Revolutionary MD , Department of Medical Research, Denver, Colorado
| | - T Richard Fort
- 4 CereScan Corporation , Department of Imaging Research, Littleton, Colorado
| | - Dennis Helffenstein
- 5 Colorado Neuropsychological Associates , Testing Department, Englewood, Colorado
| | - Thomas J Burke
- 6 University of Colorado School of Medicine, Department of Physiology (Retired) , Aurora, Colorado
| | - Shane A Quint
- 4 CereScan Corporation , Department of Imaging Research, Littleton, Colorado
| | - Garrett Bussiere
- 4 CereScan Corporation , Department of Imaging Research, Littleton, Colorado
| | - Michael Stone
- 7 Veterans Administration Hospital , Department of Radiology, Las Vegas, Nevada
| | - Timothy Hurtado
- 8 Penrose-St. Francis Health Services , Emergency Department, Colorado Springs, Colorado
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Perfusion Magnetic Resonance Imaging Changes in Normal Appearing Brain Tissue after Radiotherapy in Glioblastoma Patients may Confound Longitudinal Evaluation of Treatment Response. Radiol Oncol 2018; 52:143-151. [PMID: 30018517 PMCID: PMC6043875 DOI: 10.2478/raon-2018-0022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 04/04/2018] [Indexed: 11/21/2022] Open
Abstract
Background The aim of this study was assess acute and early delayed radiation-induced changes in normal-appearing brain tissue perfusion as measured with perfusion magnetic resonance imaging (MRI) and the dependence of these changes on the fractionated radiotherapy (FRT) dose level. Patients and methods Seventeen patients with glioma WHO grade III-IV treated with FRT were included in this prospective study, seven were excluded because of inconsistent FRT protocol or missing examinations. Dynamic susceptibility contrast MRI and contrast-enhanced 3D-T1-weighted (3D-T1w) images were acquired prior to and in average (standard deviation): 3.1 (3.3), 34.4 (9.5) and 103.3 (12.9) days after FRT. Pre-FRT 3D-T1w images were segmented into white- and grey matter. Cerebral blood volume (CBV) and cerebral blood flow (CBF) maps were calculated and co-registered patient-wise to pre-FRT 3D-T1w images. Seven radiation dose regions were created for each tissue type: 0-5 Gy, 5-10 Gy, 10-20 Gy, 20-30 Gy, 30-40 Gy, 40-50 Gy and 50-60 Gy. Mean CBV and CBF were calculated in each dose region and normalised (nCBV and nCBF) to the mean CBV and CBF in 0-5 Gy white- and grey matter reference regions, respectively. Results Regional and global nCBV and nCBF in white- and grey matter decreased after FRT, followed by a tendency to recover. The response of nCBV and nCBF was dose-dependent in white matter but not in grey matter. Conclusions Our data suggest that radiation-induced perfusion changes occur in normal-appearing brain tissue after FRT. This can cause an overestimation of relative tumour perfusion using dynamic susceptibility contrast MRI, and can thus confound tumour treatment evaluation.
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Zamboni P, Menegatti E, Cittanti C, Sisini F, Gianesini S, Salvi F, Mascoli F. Fixing the jugular flow reduces ventricle volume and improves brain perfusion. J Vasc Surg Venous Lymphat Disord 2018; 4:434-45. [PMID: 27638998 DOI: 10.1016/j.jvsv.2016.06.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Accepted: 06/09/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Increased ventricle volume and brain hypoperfusion are linked to neurodegeneration. We hypothesized that in patients with restricted jugular flow, surgical restoration may reduce brain ventricle volume, because it should improve the pressure gradient, hence promoting cerebrospinal fluid reabsorption into the venous system. METHODS The effects of restoring the jugular flow were assessed by means of a validated echocardiography with color Doppler (ECD) protocol of flow quantification, magnetic resonance venography, and single-photon emission computed tomography combined with computed tomography (SPECT-CT). The main outcome measurement was the cerebral ventricle volume blindly assessed at SPECT-CT. Secondary outcomes were brain perfusion in the whole brain and in another 12 cerebral regions. The mean follow-up of the SPECT-CT and ECD parameters was 30 days. Patency rate was subsequently monitored by means of the same ECD protocol every 3 months. RESULTS Among 56 patients (28 male and 28 female; mean age, 44 ± 10 years) with ECD screening positive for chronic cerebrospinal venous insufficiency due to nonmobile jugular leaflets, 15 patients were excluded from the initial cohort because they did not meet the inclusion and exclusion criteria. Of the remaining 41 patients, 27 patients (14 male, 13 female; mean age, 48 ± 7 years) underwent endophlebectomy and autologous vein patch angioplasty. Omohyoid muscle section was performed when appropriate. The control group comprised 14 patients matched by age and gender (8 male, 6 female; mean age, 44 ± 11 years) who were not treated. Comorbidity was multiple sclerosis without significant differences in relapsing remitting (RR) and secondary progressive (SP) clinical course among groups. In the control group, neither ECD nor SPECT-CT showed any significant changes at follow-up. On the contrary, in the group operated on, the collateral flow index went from 70% to 30% (P < .0003) thanks to improved flow through the internal jugular vein. Correspondingly, ventricle volume dramatically decreased in the treated group (from 34 ± 14 cm(3) to 31 ± 13 cm(3); P < .01). The effect was much more evident in the RR subgroup (P = .009), whereas in the SP subgroup, it was not significant. Perfusion was found to be improved in the surgical group with respect to controls, particularly in the occipital and parietal regions of the RR subgroup (P < .0001 and P = .017, respectively), but not in the SP subgroup. The probability of reducing ventricle size is increased by 13-fold (P < .03) when restoration of the jugular flow achieves a postoperative collateral flow index ≤20%. Finally, the 18-month patency rate was 74%. CONCLUSIONS Fixing the flow in the jugulars in patients with chronic cerebrospinal venous insufficiency might significantly reduce brain ventricle volume and improve cerebral perfusion. These changes are more evident in patients in the earlier stages of neurodegenerative disease.
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Affiliation(s)
- Paolo Zamboni
- Unit of Translational Surgery, Azienda Ospedaliera Universitaria di Ferrara, Cona, Ferrara, Italy.
| | - Erica Menegatti
- Unit of Translational Surgery, Azienda Ospedaliera Universitaria di Ferrara, Cona, Ferrara, Italy
| | - Corrado Cittanti
- Unit of Nuclear Medicine, Azienda Ospedaliera Universitaria di Ferrara, Cona, Ferrara, Italy
| | | | - Sergio Gianesini
- Unit of Translational Surgery, Azienda Ospedaliera Universitaria di Ferrara, Cona, Ferrara, Italy
| | | | - Francesco Mascoli
- Unit of Vascular Surgery, Azienda Ospedaliera Universitaria di Ferrara, Cona, Ferrara, Italy
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Chen CM, Huang YC, Shih CT, Chen YF, Peng SL. MRI-based measurements of whole-brain global cerebral blood flow: Comparison and validation at 1.5T and 3T. J Magn Reson Imaging 2018; 48:1273-1280. [PMID: 29479823 DOI: 10.1002/jmri.25989] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 02/08/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Whole-brain global cerebral blood flow (CBF) determined by MRI techniques, calculated using total CBF (TCBF) from phase-contrast MRI (PC-MRI), and brain parenchyma volume (BPV) from T1 -weighted image, have become increasingly popular in many applications. PURPOSE/HYPOTHESIS To determine if MRI-based measurements of whole-brain global CBF data obtained across different field strengths could be merged, TCBF and BPV data acquired at 1.5T and 3T were compared. STUDY TYPE Prospective study. POPULATION Seventeen healthy subjects (eight females, aged 21-29 years old). FIELD STRENGTH/SEQUENCE Fast spoiled gradient echo (FSPGR) and PC-MRI at both 1.5T and 3T. ASSESSMENT TCBF and BPV data acquired at 1.5T and 3T were compared. STATISTICAL TESTS The relationships of TCBF and whole-brain global CBF between two field strengths were examined by using the Pearson correlation coefficient analysis and intraclass correlation coefficient (ICC). RESULTS Regression analysis revealed a strong correlation between TCBF at two field strengths (R2 = 0.78, P < 0.001), and the ICC was 0.85, suggesting measurements of TCBF at 1.5T were comparable and correlated with those at 3T. There was a significant difference in BPV between field strengths, where the white matter estimate was significantly larger at 1.5T when compared with that at 3T (P < 0.001). When TCBF was further normalized to the brain parenchyma mass to obtain whole-brain global CBF, it only showed a moderate correlation between measurements at the two field strengths (R2 = 0.46, P = 0.003) and lower ICC of 0.66, reflecting the slightly higher interstrength variability in the whole-brain global CBF measurements. DATA CONCLUSION TCBF measurements could be performed equally well with comparable results at both field strengths, but specific attention should be given when TCBF is further normalized to BPV to obtain whole-brain global CBF. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:1273-1280.
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Affiliation(s)
- Chun-Ming Chen
- Department of Radiology, China Medical University Hospital, Taichung, Taiwan
| | - Yen-Chih Huang
- Department of Radiology, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Ting Shih
- 3D Printing Medical Research Center, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Yung-Fang Chen
- Department of Radiology, China Medical University Hospital, Taichung, Taiwan
| | - Shin-Lei Peng
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
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Nardo D, Högberg G, Jonsson C, Jacobsson H, Hällström T, Pagani M. Neurobiology of Sleep Disturbances in PTSD Patients and Traumatized Controls: MRI and SPECT Findings. Front Psychiatry 2015; 6:134. [PMID: 26441695 PMCID: PMC4585117 DOI: 10.3389/fpsyt.2015.00134] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 09/11/2015] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Sleep disturbances such as insomnia and nightmares are core components of post-traumatic stress disorder (PTSD), yet their neurobiological relationship is still largely unknown. We investigated brain alterations related to sleep disturbances in PTSD patients and controls by using both structural and functional neuroimaging techniques. METHOD Thirty-nine subjects either developing (n = 21) or not developing (n = 18) PTSD underwent magnetic resonance imaging and a symptom-provocation protocol followed by the injection of 99mTc-hexamethylpropyleneamineoxime. Subjects were also tested with diagnostic and self-rating scales on the basis of which a Sleep Disturbances Score (SDS; i.e., amount of insomnia/nightmares) was computed. RESULTS Correlations between SDS and gray matter volume (GMV)/regional cerebral blood flow (rCBF) were computed in the whole sample and separately in the PTSD and control groups. In the whole sample, higher sleep disturbances were associated with significantly reduced GMV in amygdala, hippocampus, anterior cingulate, and insula; increased rCBF in midbrain, precuneus, and insula; and decreased rCBF in anterior cingulate. This pattern was substantially confirmed in the PTSD group, but not in controls. CONCLUSION Sleep disturbances are associated with GMV loss in anterior limbic/paralimbic, PTSD-sensitive structures and with functional alterations in regions implicated in rapid eye movement-sleep control, supporting the existence of a link between PTSD and sleep disturbance.
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Affiliation(s)
- Davide Nardo
- Neuroimaging Laboratory, Santa Lucia Foundation , Rome , Italy
| | - Göran Högberg
- Division of Psychiatry, Department of Clinical Neuroscience, Karolinska Institutet , Stockholm , Sweden
| | - Cathrine Jonsson
- Department of Nuclear Medicine, Karolinska University Hospital , Stockholm , Sweden
| | - Hans Jacobsson
- Department of Nuclear Medicine, Karolinska University Hospital , Stockholm , Sweden
| | - Tore Hällström
- Division of Psychiatry, Department of Clinical Neuroscience, Karolinska Institutet , Stockholm , Sweden ; Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden
| | - Marco Pagani
- Department of Nuclear Medicine, Karolinska University Hospital , Stockholm , Sweden ; Institute of Cognitive Sciences and Technologies, National Research Council , Rome , Italy
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Adriaens A, Polis I, Waelbers T, Vandermeulen E, Dobbeleir A, De Spiegeleer B, Peremans K. NORMAL REGIONAL DISTRIBUTION OF CEREBRAL BLOOD FLOW IN DOGS: COMPARISON BETWEEN 99m
Tc-ETHYLCYSTEINATE DIMER AND 99m
Tc- HEXAMETHYLPROPYLENE AMINE OXIME SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY. Vet Radiol Ultrasound 2013; 54:403-407. [DOI: 10.1111/vru.12028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 02/08/2013] [Indexed: 11/28/2022] Open
Affiliation(s)
- Antita Adriaens
- Faculty of Veterinary Medicine, Department of Small Animal Medicine; Ghent University; Merelbeke Belgium
| | - Ingeborgh Polis
- Faculty of Veterinary Medicine, Department of Small Animal Medicine; Ghent University; Merelbeke Belgium
| | - Tim Waelbers
- Faculty of Veterinary Medicine, Department of Small Animal Medicine; Ghent University; Merelbeke Belgium
| | - Eva Vandermeulen
- Faculty of Veterinary Medicine; Department of Medical Imaging and Small Animal Orthopedics; Ghent University; Merelbeke Belgium
| | - André Dobbeleir
- Faculty of Veterinary Medicine; Department of Medical Imaging and Small Animal Orthopedics; Ghent University; Merelbeke Belgium
- Department of Nuclear Medicine; Ghent University Hospital; Ghent Belgium
| | - Bart De Spiegeleer
- Drug Quality & Registration (DruQuaR) group; Faculty of Pharmaceutical Sciences; Ghent University; Ghent Belgium
| | - Kathelijne Peremans
- Faculty of Veterinary Medicine; Department of Medical Imaging and Small Animal Orthopedics; Ghent University; Merelbeke Belgium
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YANG BANGHUNG, WANG SHYHJEN, CHOU YUANHWA, SU TUNGPING, CHEN JYHCHENG. THE EFFECT OF TEMPLATES ON 99MTC-ECD SPECT HEALTHY BRAIN PERFUSION ANALYSIS USING STATISTICAL PARAMETRIC MAPPING. BIOMEDICAL ENGINEERING: APPLICATIONS, BASIS AND COMMUNICATIONS 2012. [DOI: 10.4015/s1016237206000440] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Objective: In vivo stability of tracer distribution of 99mTc-ECD SPECT images for healthy individuals are important to the application of regional cerebral blood flow (rCBF) in neurological studies. Statistical parametric mapping (SPM) software has been designed for voxel-by-voxel analysis of the whole brain imaging. Spatial normalization is the essential preprocessing step to transform individual images into the MNI standard template which corresponds with Talairach anatomic coordinates. However, the SPECT standard template provided with SPM2 software is 99mTc-HMPAO brain perfusion image. The purpose of this study was to evaluate the outcome of templates on 99mTc-ECD test-retest study of healthy brain perfusion analysis. Material and Methods: Fifteen healthy volunteers were included in this study. SPECT images were acquired at 30 minutes after injection of 740 MBq of 99mTc-ECD. We utilized three kinds of spatial normalization templates to assess the outcome of 99mTc-ECD test-retest study: (1) the standard SPM2 SPECT template; (2) an 99mTc-ECD template; and (3) an MRI-based normalization template. Statistical model of paired t-test was applied and the changes of rCBF were significant if corrected p value was less than 0.05. Results: Test-retest of 99mTc-ECD images showed no changes of rCBF in each template. However, we found there are slight differences among the different normalization templates. Conclusion: Investigations of rCBF under varying input conditions, such as physiological state, could be neglected. Thus, we have good reproducibility of 99mTc-ECD images. In addition, using anatomical normalization, which requires MRI data from individual subject, may be the best spatial transformation approach.
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Affiliation(s)
- BANG-HUNG YANG
- Department of Nuclear Medicine, Taipei Veterans General Hospital, Taiwan
- Faculty of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taiwan
| | - SHYH-JEN WANG
- Department of Nuclear Medicine, Taipei Veterans General Hospital, Taiwan
- National Yang-Ming University Medical School, Taiwan
| | - YUAN-HWA CHOU
- National Yang-Ming University Medical School, Taiwan
- Department of Psychiatry, Taipei Veterans General Hospital, Taiwan
| | - TUNG-PING SU
- National Yang-Ming University Medical School, Taiwan
- Department of Psychiatry, Taipei Veterans General Hospital, Taiwan
| | - JYH-CHENG CHEN
- Faculty of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taiwan
- Taipei City Hospital, Department of Education and Research, Taipei, Taiwan
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Gardner A, Pagani M, Beier H, Jacobsson H, Larsson SA, Hällström T. 99mTc-HMPAO distribution at SPECT is associated with succinate-cytochrome c reductase (SCR) activity in subjects with psychiatric disorders. Nucl Med Biol 2004; 31:277-82. [PMID: 15013494 DOI: 10.1016/s0969-8051(03)00130-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2003] [Revised: 06/26/2003] [Accepted: 07/16/2003] [Indexed: 10/26/2022]
Abstract
The origin of altered (99m)Tc-HMPAO distribution at SPECT in psychiatric disorders is unknown. Correlations between brain (99m)Tc-HMPAO distribution and muscle succinate-cytochrome c reductase (SCR, complex II + III) were assessed in 20 unmedicated psychiatric patients. Significant negative correlations were found between (99m)Tc-HMPAO distribution in associative sensory regions and SCR activity. Sensory cortices are normally enriched in complex II activity. The production of electrons and reactive oxygen species affecting the redox state is considered to be highest from complex III, but complex II may also contribute. The negative relationship between (99m)Tc-HMPAO uptake and SCR activity may be due to redox state alterations influencing fixation of the radiopharmaceutical.
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Affiliation(s)
- Ann Gardner
- NEUROTEC Department, Section of Psychiatry, Karolinska Institutet, Huddinge University Hospital, Stockholm, Sweden.
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12
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Björkstén KS, Ekberg S, Säfström P, Dige N, Granerus G. A computerized human reference brain for rCBF/SPET technetium-99m exametazime (HMPAO) investigation of elderly. Clin Physiol Funct Imaging 2004; 24:196-204. [PMID: 15233833 DOI: 10.1111/j.1475-097x.2004.00548.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Using the bull's eye approach, a reference brain from the single photon emission tomography (SPET) images of 10 subjects aged 62-81 years with excellent mental and physical health was constructed. SPET images were acquired twice, 1 week apart, using a single detector rotating gamma camera collecting 64 planar images over a 360 degrees orbit. The centre of each transaxial slice was first defined with an automatic edge detecting algorithm applied to an anterior-posterior and a side profile of the brain. Each slice was divided into 40 sectors. Maximum counts/pixel in each sector was picked. The 40 maximum count values from one transaxial slice were allowed to form a horizontal row in a new parametric image on the x-axis and slice number from the vertex to the basal parts of the brain on the y-axis. This new image was scaled to a 64 x 16 pixel matrix by interpolation, which meant a normalization of all studies to the same size. The parametric image in each subject was scaled with regard to intensity by a factor calculated by a normalization procedure using the least squares analysis. Mean and SD for each pixel were calculated, thereby constructing a "mean parametric image", and a "SD parametric image". These two images are meant to be used as the reference brain for evaluation of patient studies. This method can be used for objective measurements of diffuse brain changes and for pattern recognition in larger groups of patients. Statistical multifactorial analysis of parameters used for acquisition and data processing is possible.
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Fleming JS, Kemp PM, Bolt L, Goatman KA. Measurement of cerebral perfusion volume and 99mTc-HMPAO uptake using SPECT in controls and patients with Alzheimer's disease. Nucl Med Commun 2002; 23:1057-64. [PMID: 12411833 DOI: 10.1097/00006231-200211000-00004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Methods for quantifying the changes in brain function observed in single photon emission computed tomography (SPECT) using hexamethylenepropylene amine oxime (HMPAO) for patients with Alzheimer's disease have the potential of improving the diagnostic accuracy of the procedure and its ability to monitor response to treatment. The absolute percentage uptake of HMPAO and the cerebral perfusion volume (CPV) of the brain were assessed using SPECT in 26 patients with mild to moderate Alzheimer's disease (AD) and 24 control subjects. A subset of 15 control subjects, which was age-matched to the AD patients, was selected to allow fair statistical comparison of parameters between groups. The percentage of brain volume with reduced perfusion (R) and a volume loss index (VLI), given by /CPV, were also calculated. Eight of the control subjects were studied on a second occasion after a mean period of 6 months. There was no significant difference in percentage uptake between controls and AD patients, the mean value being 5.8%. Cerebral perfusion volume in controls was found to depend on sex (mean value in males and females being 1327 ml and 1222 ml, respectively) and on age. The volume loss index corrected for age and sex provided good discrimination between controls and AD subjects giving a sensitivity and specificity of 81% and 96%, respectively. The repeatability coefficient, the 95% confidence limit for the difference between repeat measurements, on controls was 67 ml (5%). The measurement of cerebral perfusion volume and related indices may be of value in identifying patients with early Alzheimer's disease and in following their response to treatment.
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Affiliation(s)
- J S Fleming
- Department of Medical Physics and Bioengineering, Southampton University Hospitals NHS Trust, UK.
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14
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Taki S, Higashi K, Oguchi M, Tamamura H, Tsuji S, Ohta K, Tonami H, Yamamoto I, Okamoto K, Iizuka H. Changes in regional cerebral blood flow in irradiated regions and normal brain after stereotactic radiosurgery. Ann Nucl Med 2002; 16:273-7. [PMID: 12126097 DOI: 10.1007/bf03000106] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To elucidate the radiation effect on the normal brain after stereotactic radiosurgery (SRS), we evaluated the change in regional cerebral blood flow (CBF) in targeted and extra-targeted areas according to the radiation dose given. METHODS Thirteen patients who underwent SRS for brain tumors or arteriovenous malformations were included in this study. Maximum radiation doses to the lesion ranged from 24 to 37 Gy. Mean and regional CBF were measured by 99mTc-HMPAO scintigraphy with graphic analysis, performed at before, 2 weeks and 3 months (5 patients) after SRS. Under the co-registration with the CT with superimposed isodose distribution, ROIs were set on target (37-20 Gy), peri-target (20-5 Gy) and out-of-field (5-2 Gy and less than 2 Gy) areas on the quantitative SPECT images. RESULTS Significant reductions in mean CBF (by 7%) and regional CBF in the peri-target areas (by 5-7%) and out-of-field areas (by 6-22%) were recognized at 2 weeks and 3 months after SRS. Regional CBF in the target and peri-target areas did not significantly change, presumably because there was little or no normal tissue in these areas. CONCLUSION These results suggest that subclinical regional CBF reduction occurs after SRS in the normal brain in out-of-field of radiation.
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Affiliation(s)
- Suzuka Taki
- Department of Radiology, Kanazawa Medical University, Uchinada, Kahoku, Japan.
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15
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Gardner A, Pagani M, Jacobsson H, Lindberg G, Larsson SA, Wägner A, Hällstrom T. Differences in resting state regional cerebral blood flow assessed with 99mTc-HMPAO SPECT and brain atlas matching between depressed patients with and without tinnitus. Nucl Med Commun 2002; 23:429-39. [PMID: 11973483 DOI: 10.1097/00006231-200205000-00002] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
An increased occurrence of major depressive disorder has been reported in tinnitus patients, and of tinnitus in depressive patients. Involvement of several Brodmann areas (BAs) has been reported in tinnitus perception. The aim of this study was to assess the regional cerebral blood flow (rCBF) changes in depressed patients with and without tinnitus. The rCBF distribution at rest was compared among 45 patients with a lifetime prevalence of major depressive disorder, of whom 27 had severe tinnitus, and 26 normal healthy subjects. 99mTc-hexamethylenepropylene amine oxime (99mTc-HMPAO) single photon emission computed tomography (SPECT), using a three-headed gamma camera, was performed and the uptake in 34 functional sub-volumes of the brain bilaterally was assessed by a computerized brain atlas. Decreased rCBF in right frontal lobe BA 45 (P<0.05), the left parietal lobe BA 39 (P<0.00) and the left visual association cortex BA 18 (P<0.05) was found in tinnitus patients compared with non-tinnitus patients. The proportion of tinnitus patients with pronounced rCBF alterations in one or more of the temporal lobe BAs 41+21+22 was increased compared to gender matched controls (P<0.00) and patients without tinnitus (P<0.05). Positive correlations were found between trait anxiety scales from the Karolinska Scales of Personality and rCBF in tinnitus patients only in three limbic BAs (P<0.01), and inverse correlations in non-tinnitus patients only in five BAs subserving auditory perception and processing (P<0.05). rCBF differences between healthy controls and depressed patients with and without tinnitus were found in this study. The rCBF alterations were distributed in the cortex and were particularly specific in the auditory cortex. These findings suggest that taking audiological symptoms into account may yield more consistent results between rCBF studies of depression.
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Affiliation(s)
- A Gardner
- NEUROTEC Department, Division of Psychiatry, Karolinska Institutet, Huddinge University Hospital, Stockholm, Sweden.
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16
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Lahorte P, Vandenberghe S, Van Laere K, Audenaert K, Lemahieu I, Dierckx RA. Assessing the performance of SPM analyses of spect neuroactivation studies. Statistical Parametric Mapping. Neuroimage 2000; 12:757-64. [PMID: 11112407 DOI: 10.1006/nimg.2000.0658] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Several simulations of SPECT neuroactivation studies have been performed in order to determine the influence of both study size and activation focus characteristics on the detection of brain activation foci following a pixel-based statistical analysis. This was achieved by developing a methodology based on the Hoffman software brain phantom, SPECT acquisition simulation software, standard reconstruction software, and the Statistical Parametric Mapping (SPM96) package. We present results on the minimal activation levels required for focus detection. Furthermore, the improved sensitivity of the analysis resulting from the use of an iterative reconstruction technique (OSEM) with regard to the classical filtered backprojection (FBP) is assessed quantitatively, and the various physical, processing, and physiological parameters that potentially influence the detection of foci are discussed. Finally, the influence is investigated of the height threshold as implemented in SPM96 upon the size of the detected foci. Practical guidelines are proposed with regard to the number of subjects per group for SPECT activation studies following the split-dose design.
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Affiliation(s)
- P Lahorte
- Department of Subatomic and Radiation Physics, Radiation Physics Group, Ghent University, Proeftuinstraat 86, B-9000 Ghent, Belgium
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