title: Central benzodiazepine receptor binding potential and CBF images on SPECT correlate with oxygen extraction fraction images on PET in the cerebral cortex with unilateral major cerebral artery occlusive disease.
abstract: Oxygen extraction fraction (OEF) is a key predictor of stroke recurrence in patients with symptomatic major cerebral arterial occlusive disease. The purpose of the present study was to compare central benzodiazepine receptor binding potential (BRBP) and cerebral blood flow (CBF) images on SPECT with OEF images on PET in patients with chronic unilateral middle cerebral artery (MCA) or internal carotid artery (ICA) occlusive disease.
  
  
  METHODS
  OEF, CBF, and BRBP were assessed using (15)O PET and N-isopropyl-p-(123)I-iodoamphetamine and (123)I-iomazenil SPECT, respectively, in 20 healthy subjects and in 34 patients with unilateral MCA or ICA occlusive disease. All images were transformed into the standard brain size and shape by linear and nonlinear transformation using statistical parametric mapping for anatomic standardization. A region of interest (ROI) was automatically placed according to the arterial supply using a 3-dimensional stereotactic ROI template, and the ratio of the value in the affected side to that in the contralateral side was calculated in each image.
  
  
  RESULTS
  Among patients with occlusive disease, a significant positive correlation was observed between PET OEF and SPECT BRBP/CBF ratios in 3 cerebral cortical regions (r = 0.851, P < 0.0001, for anterior cerebral artery [ACA] ROI; r = 0.807, P < 0.0001, for MCA ROI; and r = 0.774, P < 0.0001, for posterior cerebral artery [PCA] ROI), but there were no correlations between these 2 parameters in the basal ganglia or the cerebellum. When an abnormally elevated PET OEF ratio was defined as a value greater than the mean + 2 SDs obtained in healthy subjects, sensitivity and specificity were, respectively, 100% and 96% for the ACA ROI, 100% and 89% for the MCA ROI, and 100% and 93% for the PCA ROI for the SPECT BRBP/CBF ratio for detecting an abnormally elevated PET OEF ratio.
  
  
  CONCLUSIONS
  BRBP/CBF images on SPECT correlate with OEF images on PET in a specific clinical setting-that is, in the cerebral cortex of patients with chronic unilateral MCA or ICA occlusive disease.
authors.affiliation: Department of Neurosurgery, School of Medicine, Iwate Medical University, Morioka, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Chida
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Ogasawara
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kuroda
authors.forename: Kenta
authors.initials: K
authors.lastname: Aso
authors.forename: Masakazu
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Shunrou
authors.initials: S
authors.lastname: Fujiwara
authors.forename: Kenji
authors.initials: K
authors.lastname: Yoshida
authors.forename: Kazunori
authors.initials: K
authors.lastname: Terasaki
authors.forename: Akira
authors.initials: A
authors.lastname: Ogawa
mesh_terms: D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging* / Q000378:metabolism*; D001479:Basal Ganglia / Q000000981:diagnostic imaging / Q000378:metabolism; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000378:metabolism; D002531:Cerebellum / Q000000981:diagnostic imaging / Q000378:metabolism; D002540:Cerebral Cortex / Q000000981:diagnostic imaging* / Q000378:metabolism*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D005442:Flumazenil / Q000031:analogs & derivatives; D006801:Humans; D007091:Image Processing, Computer-Assisted; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000378:metabolism; D020765:Intracranial Arterial Diseases / Q000000981:diagnostic imaging* / Q000378:metabolism*; D020367:Iofetamine; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology*; D010104:Oxygen Radioisotopes; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D011963:Receptors, GABA-A / Q000378:metabolism*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D010104:Oxygen Radioisotopes; D019275:Radiopharmaceuticals; D011963:Receptors, GABA-A; D005442:Flumazenil; C063038:iomazenil; D020367:Iofetamine