title: Probabilistic map of blood flow distribution in the brain from the internal carotid artery.
abstract: Brain single photon emission computed tomographic (SPECT) images acquired after injecting Tc-99m-HMPAO into the internal carotid artery (ICA) during an intracarotid amobarbital procedure (IAP SPECT) provide anatomical information on the blood flow distribution from the ICA. In this study, probabilistic maps of the distribution of blood supply from the ICA were developed using the IAP SPECT images. Twenty-two sets of basal and IAP SPECT were collected from an existing database. IAP SPECT images were coregistered to basal SPECT images, and spatial normalization parameters used for basal SPECT images were reapplied to IAP SPECT for anatomical standardization. Pixel counts of IAP SPECT images were then normalized, and the probabilistic map of cerebral perfusion distribution (perfusion probabilistic map) for each hemisphere was determined by averaging the spatial/count-normalized IAP SPECT images. Population-based probabilistic maps representing the extent of ICA territory (extent probabilistic map) were also composed by averaging the binary images obtained by thresholding the spatially normalized IAP SPECT images. The probabilistic maps were used to quantify cerebral perfusion and reserve change after arterial bypass surgery in 10 patients with ICA stenosis. In the probabilistic maps, blood supply from the ICA was found to be most likely in the dorsolateral frontal lobe, the anterosuperior portion of the temporal lobe, and in the frontoparietal area. Of the subcortical regions, the striatum was found to be most likely to derive its blood supply from ICA. In patients with cerebral occlusive disease, improvements in basal perfusion and perfusion reserve in the bypass-grafted ICA territory were well identified and were increased by 6.2% and 4.6%, respectively, on average. The probabilistic maps developed in this study illustrate the perfusion distribution and extent of vascular territory for ICA and would be useful for objective evaluations of perfusion status in cerebrovascular disease.
authors.affiliation: Department of Nuclear Medicine, Seoul National University, College of Medicine, Seoul 110-744, Korea.
authors.forename: Jae Sung
authors.initials: JS
authors.lastname: Lee
authors.forename: Dong Soo
authors.initials: DS
authors.lastname: Lee
authors.forename: Yu Kyeong
authors.initials: YK
authors.lastname: Kim
authors.forename: Jinsu
authors.initials: J
authors.lastname: Kim
authors.forename: Ho Young
authors.initials: HY
authors.lastname: Lee
authors.forename: Sang Kun
authors.initials: SK
authors.lastname: Lee
authors.forename: June-Key
authors.initials: JK
authors.lastname: Chung
authors.forename: Myung Chul
authors.initials: MC
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D000654:Amobarbital; D038481:Anterior Temporal Lobectomy; D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging* / Q000601:surgery; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000601:surgery; D004292:Dominance, Cerebral / Q000502:physiology; D004833:Epilepsy, Temporal Lobe / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D015233:Models, Statistical; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D012016:Reference Values; D012039:Regional Blood Flow / Q000502:physiology; D012189:Retrospective Studies; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D019690:Technetium Tc 99m Exametazime; D000654:Amobarbital