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Perfusion CT compared to H2 15O/O15O PET in patients with chronic cervical carotid artery occlusion

  • Diagnostic Neuroradiology
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Abstract

Introduction

The purpose of this study was to compare the results of perfusion computed tomography (PCT) with those of 15O2/H2 15O 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 15O2/H2 15O 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.

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Acknowledgment

This research was supported by USPHS grant NS42167 (William J. Powers, Principal Investigator).

Conflict of interest statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Neuroradiology Section, University of California, San Francisco, 505 Parnassus Avenue, P.O. Box 0628, San Francisco, CA, 94143-0628, USA

    Amita Kamath, Jeffrey D. Chien, William P. Dillon & Max Wintermark

  2. Department of Neurology, University of California, San Francisco, CA, USA

    Wade S. Smith

  3. Department of Neurology, University of North Carolina, Chapel Hill, NC, USA

    William J. Powers

  4. Department of Bioimages and Radiological Sciences, Catholic University of Sacred Heart—Rome, Policlinico “A. Gemelli”, Rome, Italy

    Alessandro Cianfoni

  5. Departments of Neurology and Radiology, Washington University School of Medicine, St. Louis, MO, USA

    Tom Videen

  6. Department of Neurosurgery, University of California, San Francisco, CA, USA

    Michael T. Lawton

  7. Northern California PET Imaging Center, Sacramento, CA, USA

    Bruce Finley

Authors
  1. Amita Kamath
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  2. Wade S. Smith
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  3. William J. Powers
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  4. Alessandro Cianfoni
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  5. Jeffrey D. Chien
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  6. Tom Videen
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  7. Michael T. Lawton
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  8. Bruce Finley
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  9. William P. Dillon
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  10. Max Wintermark
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Corresponding author

Correspondence to Max Wintermark.

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Kamath, A., Smith, W.S., Powers, W.J. et al. Perfusion CT compared to H2 15O/O15O PET in patients with chronic cervical carotid artery occlusion. Neuroradiology 50, 745–751 (2008). https://doi.org/10.1007/s00234-008-0403-9

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  • DOI: https://doi.org/10.1007/s00234-008-0403-9

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