Evaluation of both perfusion and atrophy in multiple system atrophy of the cerebellar type using brain SPECT alone

Hiroshi Matsuda,Noriko Sato,Yasumasa Shimano,Etsuko Imabayashi,Kimiteru Ito,Daisuke Kikuta,Minoru Yamada,Akira Seto,Ichiei Kuji

doi:10.1186/1471-2342-10-17

Abstract

BackgroundPartial volume effects in atrophied areas should be taken into account when interpreting brain perfusion single photon emission computed tomography (SPECT) images of neurodegenerative diseases. To evaluate both perfusion and atrophy using brain SPECT alone, we developed a new technique applying tensor-based morphometry (TBM) to SPECT.MethodsAfter linear spatial normalization of brain perfusion SPECT using 99mTc-ethyl cysteinate dimer (99mTc-ECD) to a Talairach space, high-dimension-warping was done using an original 99mTc-ECD template. Contraction map images calculated from Jacobian determinants and spatially normalized SPECT images using this high-dimension-warping were compared using statistical parametric mapping (SPM2) between two groups of 16 multiple system atrophy of the cerebellar type (MSA-C) patients and 73 age-matched normal controls. This comparison was also performed in conventionally warped SPECT images.ResultsSPM2 demonstrated statistically significant contraction indicating local atrophy and decreased perfusion in the whole cerebellum and pons of MSA-C patients as compared to normal controls. Higher significance for decreased perfusion in these areas was obtained in high-dimension-warping than in conventional warping, possibly due to sufficient spatial normalization to a 99mTc-ECD template in high-dimensional warping of severely atrophied cerebellum and pons. In the present high-dimension-warping, modification of tracer activity remained within 3% of the original tracer distribution.ConclusionsThe present new technique applying TBM to brain SPECT provides information on both perfusion and atrophy at the same time thereby enhancing the role of brain perfusion SPECT

Highlights

Partial volume effects in atrophied areas should be taken into account when interpreting brain perfusion single photon emission computed tomography (SPECT) images of neurodegenerative diseases
Particular attention must be paid to local atrophy when interpreting brain SPECT images in neurodegenerative diseases, since tracer activity determined by SPECT with limited spatial resolution is greatly influenced by partial volume effects
We developed a new technique to evaluate both perfusion and atrophic changes at the same time using brain SPECT alone, and applied this technique to patients with multiple system atrophy of the cerebellar type (MSA-C) for clinical validation

Summary

Introduction

Partial volume effects in atrophied areas should be taken into account when interpreting brain perfusion single photon emission computed tomography (SPECT) images of neurodegenerative diseases. To evaluate both perfusion and atrophy using brain SPECT alone, we developed a new technique applying tensorbased morphometry (TBM) to SPECT. Contraction map images calculated from Jacobian determinants and spatially normalized SPECT images using this high-dimensionwarping were compared using statistical parametric mapping (SPM2) between two groups of 16 multiple system atrophy of the cerebellar type (MSA-C) patients and 73 age-matched normal controls This comparison was performed in conventionally warped SPECT images.

Methods

Results

Discussion

Conclusion