Perfusion CT compared to H(2) (15)O/O (15)O PET in patients with chronic cervical carotid artery occlusion

Document Type

Article

Abstract

INTRODUCTION: The purpose of this study was to compare the results of perfusion computed tomography (PCT) with those of (15)O(2)/H(2) (15)O positron emission tomography (PET) in a subset of Carotid Occlusion Surgery Study (COSS) patients. MATERIALS AND METHODS: Six patients enrolled in the COSS underwent a standard-of-care PCT in addition to the (15)O(2)/H(2) (15)O PET study used for selection for extracranial-intracranial bypass surgery. PCT and PET studies were coregistered and then processed separately by different radiologists. Relative measurement of cerebral blood flow (CBF) and oxygen extraction fraction (OEF) were calculated from PET. PCT datasets were processed using different arterial input functions (AIF). Relative PCT and PET CBF values from matching regions of interest were compared using linear regression model to determine the most appropriate arterial input function for PCT. Also, PCT measurements using the most accurate AIF were evaluated for linear regression with respect to relative PET OEF values. RESULTS: The most accurate PCT relative CBF maps with respect to the gold standard PET CBF were obtained when CBF values for each arterial territory are calculated using a dedicated AIF for each territory (R (2) = 0.796, p < 0.001). PCT mean transit time (MTT) is the parameter that showed the best correlation with the count-based PET OEF ratios (R (2) = 0.590, p < 0.001). CONCLUSION: PCT relative CBF compares favorably to PET relative CBF in patients with chronic carotid occlusion when processed using a dedicated AIF for each territory. The PCT MTT parameter correlated best with PET relative OEF.

Medical Subject Headings

Adult; Aged; Brain Ischemia (diagnosis, physiopathology, therapy); Carotid Artery Diseases (diagnosis, physiopathology, therapy); Carotid Artery, Internal; Cerebrovascular Circulation (physiology); Cohort Studies; Female; Humans; Male; Middle Aged; Positron-Emission Tomography; Predictive Value of Tests; Retrospective Studies; Tomography, X-Ray Computed (methods)

Publication Date

5-30-2008

Publication Title

Neuroradiology

ISSN

0028-3940

Volume

50

Issue

9

First Page

745

Last Page

51

PubMed ID

18509627

Digital Object Identifier (DOI)

10.1007/s00234-008-0403-9

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