Abstract
Recent Japanese EC-IC Bypass Trial (JET Study) showed that the EC-IC Bypass was beneficial for stroke prevention in patients with Stage II hemodynamic cerebral ischemia determined by quantified CBF-SPECT imaging. Standardization of quantified stratification of hemodynamic cerebral ischemia using CBF-SPECT imaging will be important issue in decision-making of indication of EC-IC Bypass surgery for cerebral ischemia. In this article, we proposed newly developed two CBF-SPECT analysis for improving measurement accuracy and judgment accuracy.
Dual table ARG (DTARG) analysis provided same-day quantification of both resting CBF and acetazolamide-activated CBF using split dose of CBF tracer (IMP) and common arterial input function for im-proving measurement accuracy. In this method, resting and acetazolamide-activated CBF-SPECT could be quantified pixel-by-pixel using dual table look-up method without error of input functions.
Segmental extraction estimation (SEE) analysis presented resting CBF, acetazolamide-activated CBF, VR, and stratification of hemodynamic cerebral ischemia unfolded on the standardized brain surface coordinate using 3-dimensional stereotactic surface projections (3D-SSP) for improving judgment accuracy. In this analysis, severity of hemodynamic cerebral ischemia could be estimated from both stereotactic and quantitative viewpoints based on standardized vascular territories. Standardization of quantified stratification of hemodynamic cerebral ischemia using CBF-SPECT imaging will be progressed by introduction of DTARG and SEE analysis.
