IS IMAGE SUBTRACTION NECESSARY IN THE CLINICAL INTERPRETATION OF SINGLE-DAY SPLIT-DOSE STRESS CEREBRAL PERFUSION SINGLE-PHOTON EMISSION TOMOGRAPHY USING TC-99M COMPOUNDS
Cyo. Wong et al., IS IMAGE SUBTRACTION NECESSARY IN THE CLINICAL INTERPRETATION OF SINGLE-DAY SPLIT-DOSE STRESS CEREBRAL PERFUSION SINGLE-PHOTON EMISSION TOMOGRAPHY USING TC-99M COMPOUNDS, European journal of nuclear medicine, 23(10), 1996, pp. 1309-1314
The aim of this study was to validate a simplified semiquantitative me
thod of evaluating a single-day stress cerebral perfusion test to obta
in cerebrovascular reserve capacity (CVRC) for routine clinical uses,
A split-dose protocol was tested in 36 pairs of technetium-99m hexamet
hylpropylene amino oxime baseline (low dose) and acetazolamide (high d
ose) stress brain single-photon emission tomographic (SPET) studies fr
om 16 patients with cerebrovascular disease. The images were displayed
on a semiquantitative color scale with (corrected) and without (uncor
rected) image subtraction, dose adjustment, and decay correction. The
representative CVRC was determined by placing 3x3 pixel regions of int
erest on midthalamic and midcerebellar slices. The corrected and uncor
rected relative changes in CVRC were correlated using linear regressio
n. The relative changes of corrected (x) and uncorrected (y) CVRC by q
uantitative analysis were highly correlated in a linear fashion (y=0.6
7x+0.002, r=0.998, P<0.0005). As predicted by theory, the slope was re
lated to the ratio of split dose and independent of ROI sampling. Sing
le-day split-dose stress brain SPET can be accurately performed withou
t image subtraction and complicated dose adjustment or decay correctio
n for clinical studies.