title: Usefulness of dual and fully automated measurements of cerebral blood flow during balloon occlusion test of the internal carotid artery.
abstract: BACKGROUND
  This study was conducted to show the reliability of fully automated quantification of regional cerebral blood flow (rCBF) in balloon occlusion test (BOT) of the internal carotid artery (ICA). We also shows the usefulness of ratio of rCBF during BOT to rCBF at rest (BOT/rest ratio = rCBF during BOT/rCBF at rest) rather than asymmetry index (AI) during BOT (AI = occluded-side rCBF/contralateral rCBF).
  
  
  METHODS
  In the last 2 years, we performed the BOT on 10 consecutive patients (4 with intracranial aneurysms and 6 with head and neck tumors). During the BOT, mean stump pressure (MSTP) of the ICA was monitored. We measured cerebral blood flow (CBF) with technetium-99m hexamethylpropylene amine oxime single-photon emission computed tomography at rest and during BOT. rCBF was determined using 3-dimensional stereotaxic region of interest template (3DSRT) which automatically divided CBF into 12 segments. We defined hypoperfusion segment as BOT/rest ratio <0.9 or AI <0.9.
  
  
  RESULTS
  When the BOT/rest ratio was used as a hypoperfusion parameter, the number of hypoperfusion segments was significantly greater in patients with an MSTP ≤50 mm Hg than in patients with an MSTP >50 mm Hg. However, only AI during BOT did not reflect MSTP significantly.
  
  
  CONCLUSIONS
  The evaluation of CBF changes in BOT using 3DSRT and the BOT/rest ratio were useful because of objective comparison.
authors.affiliation: Department of Neurosurgery and Restorative Neuroscience, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Torigai
authors.forename: Mitsuhito
authors.initials: M
authors.lastname: Mase
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ohno
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Katano
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Nisikawa
authors.forename: Keita
authors.initials: K
authors.lastname: Sakurai
authors.forename: Shigeru
authors.initials: S
authors.lastname: Sasaki
authors.forename: Junko
authors.initials: J
authors.lastname: Toyama
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yamada
mesh_terms: D000328:Adult; D000368:Aged; D001331:Automation; D021721:Balloon Occlusion; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D003935:Diagnostic Techniques, Cardiovascular; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009361:Neoplasm Invasiveness; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D019690:Technetium Tc 99m Exametazime; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime