Tracer Delay–Insensitive Algorithm Can Improve Reliability of CT Perfusion Imaging for Cerebrovascular Steno-Occlusive Disease: Comparison with Quantitative Single-Photon Emission CT
Tracer Delay–Insensitive Algorithm Can Improve Reliability of CT Perfusion Imaging for Cerebrovascular Steno-Occlusive Disease: Comparison with Quantitative Single-Photon Emission CT
复制标题
示踪剂延迟不敏感算法可以提高脑血管狭窄闭塞性疾病 CT 灌注成像的可靠性：与定量单光子发射 CT 的比较
DOI：
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发表时间：
2008
影响因子：
3.5
通讯作者：
S. Fujiwara
中科院分区：
文献类型：
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作者：
Makoto Sasaki;Kohsuke Kudo;K. Ogasawara;S. Fujiwara
背景和目的：CT灌注（CTP）算法的可靠性尚未得到充分验证。我们研究了通过使用动态CTP技术与示踪剂延迟不敏感反卷积算法获得的脑血流量（CBF）值是否比通过使用CTP与延迟敏感算法在单侧脑血管狭窄闭塞性疾病中获得的值更准确，与定量单光子发射CT（SPECT）产生的值相比。材料和方法：使用CTP和碘-123-N-异丙基-p-碘苯丙胺SPECT与放射自显影定量技术，我们检查了20例由于单侧颈内动脉或大脑中动脉狭窄或闭塞而提示血流动力学缺血的患者。用于CTP的算法包括延迟不敏感的块循环奇异值分解（SVD）（bSVD）和延迟敏感的标准SVD（sSVD）和盒调制传递函数（bMTF）。研究结果：通过使用CTP与bSVD获得的绝对CBF值显着低于SPECT获得的值，但未受影响的一侧的比率显着相关的定量SPECT值与显着的协议，特别是当动脉输入功能从未受影响的一侧获得。相反，CBF比值与sSVD和bMTF被显著低估，CTP与sSVD或bMTF和SPECT之间没有显著的一致性，尽管它们之间的一些参数有实质性的相关性。结论：与CTP技术，去卷积算法的示踪剂延迟效应的不敏感性似乎是必不可少的估计半定量CBF值在单侧狭窄闭塞病变的患者。
BACKGROUND AND PURPOSE: Reliability of CT perfusion (CTP) algorithms has not been fully validated. We investigated whether the cerebral blood flow (CBF) values obtained by using a dynamic CTP technique with a tracer delay–insensitive deconvolution algorithm are more accurate than those obtained by using CTP with delay-sensitive algorithms in unilateral cerebrovascular steno-occlusive disease, when compared with those generated by quantitative single-photon emission CT (SPECT). MATERIALS AND METHODS: Using CTP and iodine-123-N-isopropyl-p-iodoamphetamine SPECT with an autoradiographic quantification technique, we examined 20 patients with suggested hemodynamic ischemia due to stenosis or occlusion of the unilateral internal carotid or middle cerebral artery. The algorithms used for CTP included delay-insensitive block-circulant singular value decomposition (SVD) (bSVD) and delay-sensitive standard SVD (sSVD) and box-modulation transfer function (bMTF). RESULTS: Absolute CBF values obtained by using CTP with bSVD were significantly lower than those obtained with SPECT, but the ratios to the nonaffected side were significantly correlated to the quantitative SPECT values with significant agreements, particularly when the arterial input function was obtained from the unaffected side. Contrastingly, CBF ratios with sSVD and bMTF were significantly underestimated, and no significant agreement was determined between CTP with sSVD or bMTF and SPECT, though there were substantial correlations between them in some parameters. CONCLUSIONS: With the CTP technique, the insensitivity of the deconvolution algorithm to the tracer-delay effect appears to be essential for estimating semiquantitative CBF values in patients with unilateral steno-occlusive lesions.