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CO 2 BOLD assessment of moyamoya syndrome: Validation with single photon emission computed tomography and positron emission tomography imaging

View Article: PubMed Central - PubMed

ABSTRACT

Aim: To compare the assessment of cerebrovascular reserve (CVR) using CO2BOLD magnetic resonance imaging (MRI) vs positron emission tomography (PET) and single photon emission computed tomography (SPECT) as reference standard.

Methods: Ten consecutive patients (8 women, mean age of 41 ± 26 years) with moyamoya syndrome underwent 14 pre-surgical evaluations for external-internal carotid artery bypass surgery. CVR was assessed using CO2BOLD and PET (4)/SPECT (11) with a maximum interval of 36 d, and evaluated by two experienced neuroradiologists.

Results: The inter-rater agreement was 0.81 for SPECT (excellent), 0.43 for PET (fair) and 0.7 for CO2BOLD (good). In 9/14 cases, there was a correspondence between CO2BOLD and PET/SPECT. In 4/14 cases, CVR was over-estimated in CO2BOLD, while in 1/14 case, CVR was underestimated in CO2BOLD. The sensitivity of CO2BOLD was 86% and a specificity of 43%.

Conclusion: CO2BOLD can be used for pre-surgical assessment of CVR in patients with moyamoya syndrome and combines the advantages of absent irradiation, high availability of MRI and assessment of brain parenchyma, cerebral vessels and surrogate CVR in one stop.

No MeSH data available.


Axial images of a sample patient showing reduced cerebrovascular reserve on the left hemispheric anterior cerebral artery and middle cerebral artery territories without any diminution of the cerebrovascular reserve in the cerebellum for positron emission tomography, CO2BOLD and single photon emission computed tomography and axial T2. The readings for the territories right ACM, right anterior cerebral artery (ACA), left ACM and left ACA were 0 (normal), 0, 2 (substantial reduction), 2 for reader A and 1, 0, 2, 2 for reader B for PET, 0, 1, 2, 2 and 1, 0, 2, 2 for CO2BOLD and 1, 1, 2, 2 and 1, 1, 2, 2 for SPECT. 0 = no reduction in CVR, 1 = mild reduction in CVR, 2 = severe reduction in CVR Color-scales represent: PET: Normalized accumulated activity, dimensionless under the assumption that 1 mL of tissue weights 1 g. BOLD: Statistical Z value, SPECT: Relative counts, normalized to the mean counts in the cerebellum, dimensionless. PET: Positron emission tomography; SPECT: Single photon emission computed tomography; BOLD: Blood oxygenation level dependent.
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Figure 3: Axial images of a sample patient showing reduced cerebrovascular reserve on the left hemispheric anterior cerebral artery and middle cerebral artery territories without any diminution of the cerebrovascular reserve in the cerebellum for positron emission tomography, CO2BOLD and single photon emission computed tomography and axial T2. The readings for the territories right ACM, right anterior cerebral artery (ACA), left ACM and left ACA were 0 (normal), 0, 2 (substantial reduction), 2 for reader A and 1, 0, 2, 2 for reader B for PET, 0, 1, 2, 2 and 1, 0, 2, 2 for CO2BOLD and 1, 1, 2, 2 and 1, 1, 2, 2 for SPECT. 0 = no reduction in CVR, 1 = mild reduction in CVR, 2 = severe reduction in CVR Color-scales represent: PET: Normalized accumulated activity, dimensionless under the assumption that 1 mL of tissue weights 1 g. BOLD: Statistical Z value, SPECT: Relative counts, normalized to the mean counts in the cerebellum, dimensionless. PET: Positron emission tomography; SPECT: Single photon emission computed tomography; BOLD: Blood oxygenation level dependent.

Mentions: The visual analysis of the surrogate CVT maps derived from CO2BOLD MRI, PET and SPECT images was independently performed by two neuroradiologists (Figure 3 for an example case) and the ratings were considered as independent points. All cases and all imaging modalities were independently evaluated in four vascular territories: Left/right anterior cerebral artery (ACA) and left/right middle cerebral artery (MCA) territory based on a three point rating system: 0 = no reduction in CVR, 1 = mild reduction in CVR, 2 = severe reduction in CVR.


CO 2 BOLD assessment of moyamoya syndrome: Validation with single photon emission computed tomography and positron emission tomography imaging
Axial images of a sample patient showing reduced cerebrovascular reserve on the left hemispheric anterior cerebral artery and middle cerebral artery territories without any diminution of the cerebrovascular reserve in the cerebellum for positron emission tomography, CO2BOLD and single photon emission computed tomography and axial T2. The readings for the territories right ACM, right anterior cerebral artery (ACA), left ACM and left ACA were 0 (normal), 0, 2 (substantial reduction), 2 for reader A and 1, 0, 2, 2 for reader B for PET, 0, 1, 2, 2 and 1, 0, 2, 2 for CO2BOLD and 1, 1, 2, 2 and 1, 1, 2, 2 for SPECT. 0 = no reduction in CVR, 1 = mild reduction in CVR, 2 = severe reduction in CVR Color-scales represent: PET: Normalized accumulated activity, dimensionless under the assumption that 1 mL of tissue weights 1 g. BOLD: Statistical Z value, SPECT: Relative counts, normalized to the mean counts in the cerebellum, dimensionless. PET: Positron emission tomography; SPECT: Single photon emission computed tomography; BOLD: Blood oxygenation level dependent.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5120248&req=5

Figure 3: Axial images of a sample patient showing reduced cerebrovascular reserve on the left hemispheric anterior cerebral artery and middle cerebral artery territories without any diminution of the cerebrovascular reserve in the cerebellum for positron emission tomography, CO2BOLD and single photon emission computed tomography and axial T2. The readings for the territories right ACM, right anterior cerebral artery (ACA), left ACM and left ACA were 0 (normal), 0, 2 (substantial reduction), 2 for reader A and 1, 0, 2, 2 for reader B for PET, 0, 1, 2, 2 and 1, 0, 2, 2 for CO2BOLD and 1, 1, 2, 2 and 1, 1, 2, 2 for SPECT. 0 = no reduction in CVR, 1 = mild reduction in CVR, 2 = severe reduction in CVR Color-scales represent: PET: Normalized accumulated activity, dimensionless under the assumption that 1 mL of tissue weights 1 g. BOLD: Statistical Z value, SPECT: Relative counts, normalized to the mean counts in the cerebellum, dimensionless. PET: Positron emission tomography; SPECT: Single photon emission computed tomography; BOLD: Blood oxygenation level dependent.
Mentions: The visual analysis of the surrogate CVT maps derived from CO2BOLD MRI, PET and SPECT images was independently performed by two neuroradiologists (Figure 3 for an example case) and the ratings were considered as independent points. All cases and all imaging modalities were independently evaluated in four vascular territories: Left/right anterior cerebral artery (ACA) and left/right middle cerebral artery (MCA) territory based on a three point rating system: 0 = no reduction in CVR, 1 = mild reduction in CVR, 2 = severe reduction in CVR.

View Article: PubMed Central - PubMed

ABSTRACT

Aim: To compare the assessment of cerebrovascular reserve (CVR) using CO2BOLD magnetic resonance imaging (MRI) vs positron emission tomography (PET) and single photon emission computed tomography (SPECT) as reference standard.

Methods: Ten consecutive patients (8 women, mean age of 41 ± 26 years) with moyamoya syndrome underwent 14 pre-surgical evaluations for external-internal carotid artery bypass surgery. CVR was assessed using CO2BOLD and PET (4)/SPECT (11) with a maximum interval of 36 d, and evaluated by two experienced neuroradiologists.

Results: The inter-rater agreement was 0.81 for SPECT (excellent), 0.43 for PET (fair) and 0.7 for CO2BOLD (good). In 9/14 cases, there was a correspondence between CO2BOLD and PET/SPECT. In 4/14 cases, CVR was over-estimated in CO2BOLD, while in 1/14 case, CVR was underestimated in CO2BOLD. The sensitivity of CO2BOLD was 86% and a specificity of 43%.

Conclusion: CO2BOLD can be used for pre-surgical assessment of CVR in patients with moyamoya syndrome and combines the advantages of absent irradiation, high availability of MRI and assessment of brain parenchyma, cerebral vessels and surrogate CVR in one stop.

No MeSH data available.