Partial Volume Effect Correction Research Articles

A method for quantitative assessment of renal function using dynamic contrast‐enhanced computed tomography: Evaluation of drug‐induced nephrotoxicity in rats

The authors developed a method to quantitatively evaluate renal function using dynamic contrast-enhanced computed tomography (DCE-CT) and a compartment model. They applied this method to evaluation of drug-induced nephrotoxicity in rats. They performed the DCE-CT studies using a total of 36 male Sprague-Dawley rats (n=9 for control and n=27 for treatment). The rats in the drug-treated groups were given 1.8 mg/kg/day of cis-dichlorodiammineplatinum (cisplatin) intraperitoneally every other day twice (n=9), four times (n=9), or six times (n=9). The rate constants for the transfer of the contrast agent (CA) from the intravascular space to the renal corpuscle and tubular space via glomerular filtration (K1), outflow of the CA from the renal tubules (k2), and the fraction of blood volume (f) were estimated from the DCE-CT data, and their functional images were generated using the linear least squares method. When estimating the above parameters, the partial volume effect (PVE) on the arterial input function was corrected using a calibration curve obtained by phantom experiments. The endogenous creatinine clearance (Ccr) was also measured for comparison. The K1 images became lower and more heterogeneous and the K1 values decreased significantly with increasing cisplatin injection number (3.20+/-0.73, 2.49+/-0.75, 1.80+/-0.36, and 1.27+/-0.47 ml/ml/min for control, two-, four-, and six-times treated groups, respectively). When the PVE was not corrected, the K1 values were overestimated by 15+/-3% as compared with the case when the PVE was corrected. There was a good correlation between K1 and Ccr (r=0.903 and 0.901 for cases with and without correction of PVE, respectively). In conclusion, the authors' method using DCE-CT appears to be useful for quantitatively evaluating the extent of renal dysfunction such as renal damage due to drug-induced nephrotoxicity.

P2-013: Superior Alzheimer's diagnosis by combination of partial volume effects correction and multivariate analysis in resting cerebral blood flow

P2-013: Superior Alzheimer's diagnosis by combination of partial volume effects correction and multivariate analysis in resting cerebral blood flow

IC-P3-166: Correcting for partial volume effects in perfusion MRI of Alzheimer's disease

Background: Partial volume effects (PVE) due to limited spatial resolution in brain imaging can be quite substantial, particularly in studies of Alzherimer’s Disease (AD). In arterial spin labeling (ASL) MRI, PVE are exacerbated by the nonlinear dependency of the signal on voxel tissue-heterogeneity. We have developed an algorithm that corrects for PVE in ASL and applied it to ASL data from AD and healthy controls (HC) in order to separate the true, disease-related, hypoperfusion from that due to brain atrophy. Methods: 1) The algorithm is based on linear regression and estimates the pure tissue signals by modeling the voxel magnetization as a weighted sum of MGM, MWM, and MCSF contributions and the ASL difference signal as a weighted sum of MGM and MWM contributions. The weighting coefficients in both cases are the tissue’s fractional volume, which are obtained from high-resolution structural MRIs. The algorithm is based on the assumption that local magnetization and CBF are constant over a small region surrounding the voxel. 2) Subjects & Imaging ASL perfusion images were acquired on 10 patients with moderate-to-severe probable AD and 19 age-matched HC as described in a previous study (Asllani et al, JCBFM Oct24(2007)). For each subject, linear regression was performed on control and difference ASL images in subject’s native space using a 11x11x1 regression-kernel. Images were then transformed into Talairach standard space. Results: PVE correction algorithm enables the extraction of pure GM CBF that is, theoretically, uncontaminated by contribution from WM. Global GM CBF was 57 18 and 96 21 (ml/100g*min) for AD and controls, respectively. This corresponded to 63% and 55% increases in estimation of GM CBF for AD and HC, respectively, as compared to the uncorrected method (Fig.1) Voxelwise t-statistic for between-group comparisons showed 30% more voxels surviving the statistical threshold (cluster-level corrected, P 0.001) when pure GM CBF images were used as compared to the PVEuncorrected data. These additional areas were mainly in the cingulate, inferior frontal, and superior occipital gyri (Fig.2). Conclusions: Extraction of pure tissue CBF by correcting for PVE shows great promise for providing a sensitive biomarker of early detection of AD. IC-P3-167 THE DEVELOPMENT OF SMART CONTRAST AGENTS FOR MRI IMAGING OF ALZHEIMER’S DISEASE

TH‐C‐351‐07: Partial Volume Effect Correction in PET Using Regularized Iterative Deconvolution with Variance Control Based On Local Topology

Purpose: To present a new partial volume effect (PVE) correction method for PET with variance control, which is not dependent on prior anatomical information: a necessity for radiation treatment planning. Method and Materials: The method performs post‐reconstruction iterative deconvolution using a 3D Maximum Likelihood Expectation‐Maximization algorithm. To achieve convergence a One Step Late (OSL) regularization procedure that follows the work of Alenius et al is used. This technique was further modified to selectively control the variance depending on the local topology of the PET image. Different regularization weights can be selected by the user for different parts of the image based on the signal‐to‐noise ratio. The procedure was tested for isotropic gaussian deconvolution functions with FWHM ranging from 6.31 mm to infinity. The method was applied to simulated and experimental scans of the NEMA NU‐2 image quality phantom with the GE Discovery LS PET/CT scanner and on patient scans. Results: Optimal sphere‐activity‐to‐variance ratio was obtained, when the deconvolution function was replaced by a few voxels wide step function. In this case the deconvolution method converged in ∼ 3 to 5 iterations for most points in both the simulated and experimental images. For the 1 cm diameter sphere, the contrast recovery improved from 12 % to 36 % and from 21% to 55 % for the simulated and the experimental data respectively. For the larger spheres the recovery coefficients were increased to above 68% and 80%. No increase in variance was observed except for few voxels neighboring strong activity gradients and inside the largest spheres. Testing the method using patient images indicated potential for increasing the visibility of small lesions within a non‐uniform background. Conclusion: Regularized iterative deconvolution with variance control based on local topology and on estimated image noise is a promising approach for partial volume effect corrections in PET.

Feasibility of Automated Partial-Volume Correction of SUVs in Current PET/CT Scanners: Can Manufacturers Provide Integrated, Ready-to-Use Software?

TO THE EDITOR: The article by Soret et al. ( [1][1] ) in the June 2007 issue of The Journal of Nuclear Medicine on the implications of partial-volume effect (PVE) correction for PET in cancer provides a timely review of this important subject. It is quite clear that educating physicians—who are

Reply: Feasibility of Automated Partial-Volume Correction of SUVs in Current PET/CT Scanners: Can Manufacturers Provide Integrated, Ready-to-Use Software?

REPLY: We appreciate our colleagues' observations about corrections for the partial-volume effect (PVE) in PET. They have brought up an important and timely issue—whether PET/CT manufacturers could offer PVE corrections as part of their clinical software. We agree that even if no perfectly

Comparaison de six méthodes de segmentation du volume tumoral sur la 18F-FDG TEP-TDM avec le volume de référence anatomopathologique dans les cancers bronchopulmonaires non à petites cellules

The 18F-FDG TEP has demonstrated its importance in oncology, for initial extension and efficacy of antitumoral therapeutics. Several studies have attempted to prove its utility to define tumoral volumes for conformational radiotherapy in nonsmall cell lung cancers. Some authors have suggested the use of threshold of tumor intensity uptake with 40 or 50% of maximal intensity. Black et al. have determined contouring with linear regression formula of mean semi-quantitative index of tumor uptake (standard uptake value): SUV threshold = 0.307 SUV average + 0.588. Nestlé et al. have taken into account the background noise intensity and mean intensity of the tumor: I threshold = β I average + I noise with β = 0.15. Our study was done in collaboration with Inserm U618 team and has compared volumes defined on PETscan defined according to different methods based on intensity or SUV to the tumour volume determined on CT scan by radiophysicist. We have compared those volumes with histological volume that we considered for reference. Four patients have been included. They had 18F-FDG PETscan followed by complete tumoral removal surgery. Specific histological procedure allowed to define complete size of the tumor in reexpanded lung. Comparatively to pathology, the volumes obtained using I max 40 and I max 50 are all underestimated. The volumes defined by Black's et al. method are underevaluated for the two largest tumours (15.8% to 22%) and overestimated for the two smallest ones (17.9 to 82.9%). Nestlé's et al. method, using β = 0.15, correctly estimates two tumor volumes over 2 cm, but overestimates the two small tumors (79.6 to 124%). Finally, the corrected Nestlé's et al. formula (using β = 0.264) overestimates three tumours. Volumes defined on CT scan by radiophysicist are correct for one lesion, underestimated for one and overestimated for two other ones (44 and 179.5%). Nestlé's et al. method seems to be the most accurate for tumours over 2 cm of diameter. Today no method can correctly estimate the volume of smaller tumours. To improve those segmentation approaches, partial volume effect correction needs to be implemented for small tumours or tumours close to mediastinal local extension. The main indication of segmentation based on FDG PET is tumour greater than 2 cm for which treatment will be radiotherapy alone or radiotherapy associated with chemotherapy. Our study is important because it compares the different methods described in the literature with the reference histological volume of the tumor, which is the only way to validate tumor segmentation method.

Partial volume effect correction in PET using regularized iterative deconvolution with variance control based on local topology

Correcting positron emission tomography (PET) images for the partial volume effect (PVE) due to the limited resolution of PET has been a long-standing challenge. Various approaches including incorporation of the system response function in the reconstruction have been previously tested. We present a post-reconstruction PVE correction based on iterative deconvolution using a 3D maximum likelihood expectation-maximization (MLEM) algorithm. To achieve convergence we used a one step late (OSL) regularization procedure based on the assumption of local monotonic behavior of the PET signal following Alenius et al. This technique was further modified to selectively control variance depending on the local topology of the PET image. No prior ‘anatomic’ information is needed in this approach. An estimate of the noise properties of the image is used instead. The procedure was tested for symmetric and isotropic deconvolution functions with Gaussian shape and full width at half-maximum (FWHM) ranging from 6.31 mm to infinity. The method was applied to simulated and experimental scans of the NEMA NU 2 image quality phantom with the GE Discovery LS PET/CT scanner. The phantom contained uniform activity spheres with diameters ranging from 1 cm to 3.7 cm within uniform background. The optimal sphere activity to variance ratio was obtained when the deconvolution function was replaced by a step function few voxels wide. In this case, the deconvolution method converged in ∼3–5 iterations for most points on both the simulated and experimental images. For the 1 cm diameter sphere, the contrast recovery improved from 12% to 36% in the simulated and from 21% to 55% in the experimental data. Recovery coefficients between 80% and 120% were obtained for all larger spheres, except for the 13 mm diameter sphere in the simulated scan (68%). No increase in variance was observed except for a few voxels neighboring strong activity gradients and inside the largest spheres. Testing the method for patient images increased the visibility of small lesions in non-uniform background and preserved the overall image quality. Regularized iterative deconvolution with variance control based on the local properties of the PET image and on estimated image noise is a promising approach for partial volume effect corrections in PET.

Fluoro-deoxy-glucose positron emission tomography for evaluation of indeterminate lung nodules: assigning a probability of malignancy may be preferable to binary readings

To assess the diagnostic value of fluorine-18 fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) using standard uptake values (SUV) in the differential diagnoses of indeterminate pulmonary nodules. Specifically, we assessed the probability of malignancy for various SUV ranges, and compared the diagnostic efficacy of SUV with and without correction for partial volume effects on the basis of lesion size. The FDG-PET scans performed on 158 patients with biopsy-proven pulmonary lesions seen on computed tomography (CT) scan were retrospectively reviewed. Histopathological confirmation was obtained to establish the diagnosis of the lesions. A region of interest (ROI) was drawn for each lesion, and FDG uptake was quantified (SUV(raw)). The SUV(raw) values were normalized for the "size" of the pulmonary lesions measured on CT (SUV(size)). Sensitivity and specificity of FDG-PET for pulmonary lesions <2 cm in diameter or > or =2 cm in diameter were determined at SUV cutoff values of 2.5. The areas under the receiver-operating characteristic (ROC) curve for SUV(raw) and SUV(size) regarding the presence of malignancy were compared for statistical differences. The frequency of malignant lesions for each range of SUVs was obtained to produce the probability of cancer (POC). The mean SUV(raw) was 3.17 +/- 2.76 and 9.18 +/- 6.72 for benign and malignant lesions, respectively. When a SUV(raw) value of 2.5 was used as a cutoff, sensitivity and specificity were 89% and 51%, respectively, for all lesion sizes. The sensitivity and specificity at a cutoff SUV(raw) of 2.5 for lesions less than 2 cm in diameter were 75% and 72%, respectively, and 92% and 41% for lesions 2 cm or greater, respectively. The sensitivity and specificity at a cutoff SUV(size) of 2.5 were 88% and 42%, respectively. The area under the ROC curves for SUV(raw) and SUV(size) was 0.816 and 0.743, respectively (P value 0.034). When the SUV(raw) was divided into three groups, the probability of malignancy was 26% when the SUV(raw) was <2, 57% for 2 < or = SUV(raw) < 6, and 89% for SUV(raw) > or = 6. The FDG-PET is a reasonably accurate and useful tool for characterizing the nature of indeterminate pulmonary lesions, although the specificity was not as high as that reported in the literature, probably owing in part to our patient population and selection bias. Our data suggest that reporting the results of PET studies as a probability rather than as positive or negative for malignancy would be more useful for further management decision making. Correction of SUVs for tumor size did not improve accuracy.

MRI-Based Correction for Partial-Volume Effect Improves Detectability of Intractable Epileptogenic Foci on 123I-Iomazenil Brain SPECT Images

(123)I-Iomazenil brain SPECT has been used for the detection of epileptogenic foci, especially when surgical intervention is considered. Although epileptogenic foci exhibit a decrease in (123)I-iomazenil accumulation, normal cerebral cortices often exhibit similar findings because of thin cortical ribbons, gray matter atrophy, or pathologic brain structures. In the present study, we created (123)I-iomazenil SPECT images corrected for gray matter volume using MRI and tested whether the detectability of the epileptogenic foci improved. Seven patients (1 male patient and 6 female patients; mean age +/- SD, 34 +/- 17 y) with intractable epilepsy were surgically treated by resecting the cerebral cortex after surface electroencephalography. Histopathologic examination of the resected specimens and a good outcome after surgery indicated that the resected lesions were epileptogenic foci. These patients underwent (123)I-iomazenil SPECT and 3-dimensional T1-weighted MRI examinations before their operations. Each SPECT image was coregistered to the corresponding MR image, and its partial-volume effect (PVE) was corrected on a voxel-by-voxel basis with a smoothed gray matter distribution image. Four nuclear medicine physicians visually evaluated the (123)I-iomazenil SPECT images with and without the PVE correction. The SPECT count ratio of the suspected focus to the contralateral cerebral cortex was evaluated as an asymmetry index (%) based on the volume of interest. The sensitivity, specificity, and accuracy of focus detection by visual assessment were higher after PVE correction (88%, 99%, and 98%, respectively) than before correction (50%, 92%, and 87%, respectively). The mean asymmetry index for the surgically resected lesions was significantly higher on the PVE-corrected SPECT images (22%) than on the PVE-uncorrected ones (16%) (P = 0.006). MRI-based PVE correction for (123)I-iomazenil brain SPECT improves the sensitivity and specificity of the detection of cortical epileptogenic foci in patients with intractable epilepsy.

Striatal dopamine transporter levels correlate with apathy in neurodegenerative diseases: A SPECT study with partial volume effect correction

Objectives The aim of the present study was to stress the relationship between neuropsychiatric symptoms and most particularly apathy and striatal dopamine uptake in patients with Alzheimer's disease (AD) or dementia with Lewy body (DLB). Patients and methods Twenty-two patients (AD n = 14; DLB n = 8) were included. All patients had neuropsychological and behavioral examination including Mini Mental Test Examination (MMSE), Neuropsychiatric Inventory (NPI), and UPDRS for the motor activity assessment. Apathy dimensions, emotional blunting, lack of initiative and lack of interest were assessed using the Apathy Inventory (AI). Dopamine transporter (DAT) striatal uptake was assessed using 123I-FP-CIT (DaTSCAN ®) SPECT. Quantitative measurements were obtained in 3D using a method which compensates for physical detection biases including partial volume effect. Results We observed a correlation between DAT uptake and NPI's domains only for apathy. More specifically using the AI, lack of initiative significantly correlated with bilateral putamen DAT uptake. Using partial correlation coefficients controlling for the UPDRS score, the correlation remained significant between lack of initiative and right and left putamen DAT uptake. Conclusion These results demonstrate a relationship between apathy and DAT levels independent from motor activity. They suggest that the patients with neurodegenerative diseases presenting with apathy are characterized by some degree of dopaminergic neuronal loss.

Imaging of amyloid plaques and cerebral glucose metabolism in semantic dementia and Alzheimer’s disease

Semantic dementia (SD) is a rare clinical syndrome, assigned to the group of frontotemporal lobar degenerations (FTLD). Histopathological analysis has not revealed the deposition of amyloid plaques in the majority of SD cases, in contrast to dementia of the Alzheimer type (AD). However, based on clinical examination alone a reliable differentiation of the underlying pathology cannot be guaranteed, i.e. AD and SD may be confused in some cases. Our aim was to determine, whether AD and SD can be differentiated in vivo by means of amyloid plaque PET imaging. In groups of AD and SD patients, matched for gender, age and overall degree of cognitive impairment, cerebral glucose metabolism was examined with [ 18F]Fluorodeoxyglucose (FDG)-PET and cerebral amyloid plaque density was assessed using [ 11C]6-OH-BTA-1 (PIB)-PET. A volume-of-interest analysis (VOI), using the cerebellum as a reference region, and voxel-based statistical group comparisons (SPM2) were carried out between the patient groups and matched groups of healthy controls. To control for a potential influence of atrophy on the PET findings, a correction of partial volume effects was performed. Characteristic patterns of hypometabolism could be demonstrated in both clinically defined AD and SD with some regional overlap and subtle differences (AD: bilateral posterior cingulate, temporoparietal and frontal cortex; SD: left > right polar temporal, frontal mesial cortex). Compared with healthy controls, significant [ 11C]PIB amyloid plaque tracer binding was observed only in patients with AD (in bilateral temporoparietal, frontal and posterior cingulate cortex and the precuneus) but not in SD. This difference in amyloid plaque deposition could be reproduced in direct statistical comparison of AD and SD and clearly extended the metabolic differences between the patient groups. These findings support the notion that SD can be diagnosed in vivo as a separate entity from AD using amyloid plaque imaging. In general, amyloid plaque PET may complement neuropsychological assessment regarding reliable differential diagnosis of AD and FTLD dementias based on characterization of underlying pathology and may improve the definition of individual prognosis and the selection of patients for scientific trials.

Voxel-based mapping of brain gray matter volume and glucose metabolism profiles in normal aging

With age, the brain undergoes both structural and functional alterations, probably resulting in reported cognitive declines. Relatively few investigations have sought to identify those areas that remain intact with aging, or undergo the least deterioration, which might underlie cognitive preservations. Our aim here was to establish a comprehensive profile of both structural and functional changes in the aging brain, using up-to-date voxel-based methodology (i.e. optimized voxel-based morphometry (VBM) procedure; resting-state 18FDG-PET with correction for partial volume effects (PVE)) in 45 optimally healthy subjects aged 20–83 years. Negative and positive correlations between age and both gray matter (GM) volume and 18FDG uptake were assessed. The frontal cortex manifested the greatest deterioration, both structurally and functionally, whereas the anterior hippocampus, the thalamus and (functionally) the posterior cingulate cortex were the least affected. Our results support the developmental theory which postulates that the first regions to emerge phylogenetically and ontogenetically are the most resistant to age effects, and the last ones the most vulnerable. Furthermore, the lesser affected anterior hippocampal region, together with the lesser functional alteration of the posterior cingulate cortex, appear to mark the parting of the ways between normal aging and Alzheimer's disease, which is characterized by early and prominent deterioration of both structures.

Proton echo‐planar spectroscopic imaging of J‐coupled resonances in human brain at 3 and 4 Tesla

In this multicenter study, 2D spatial mapping of J-coupled resonances at 3T and 4T was performed using short-TE (15 ms) proton echo-planar spectroscopic imaging (PEPSI). Water-suppressed (WS) data were acquired in 8.5 min with 1-cm(3) spatial resolution from a supraventricular axial slice. Optimized outer volume suppression (OVS) enabled mapping in close proximity to peripheral scalp regions. Constrained spectral fitting in reference to a non-WS (NWS) scan was performed with LCModel using correction for relaxation attenuation and partial-volume effects. The concentrations of total choline (tCho), creatine + phosphocreatine (Cr+PCr), glutamate (Glu), glutamate + glutamine (Glu+Gln), myo-inositol (Ins), NAA, NAA+NAAG, and two macromolecular resonances at 0.9 and 2.0 ppm were mapped with mean Cramer-Rao lower bounds (CRLBs) between 6% and 18% and approximately 150-cm(3) sensitive volumes. Aspartate, GABA, glutamine (Gln), glutathione (GSH), phosphoethanolamine (PE), and macromolecules (MMs) at 1.2 ppm were also mapped, although with larger mean CRLBs between 30% and 44%. The CRLBs at 4T were 19% lower on average as compared to 3T, consistent with a higher signal-to-noise ratio (SNR) and increased spectral resolution. Metabolite concentrations were in the ranges reported in previous studies. Glu concentration was significantly higher in gray matter (GM) compared to white matter (WM), as anticipated. The short acquisition time makes this methodology suitable for clinical studies.

Partial volume effect-corrected FDG PET and grey matter volume loss in patients with mild Alzheimer’s disease

Although( 18)F-fluorodeoxyglucose (FDG) PET is an established imaging technique to assess brain glucose utilisation, accurate measurement of tracer concentration is confounded by the presence of partial volume effect (PVE) due to the limited spatial resolution of PET, which is particularly true in atrophic brains such as those encountered in patients with Alzheimer's disease (AD). Our aim was to investigate the effects of PVE correction on FDG PET in conjunction with voxel-based morphometry (VBM) in patients with mild AD. Thirty-nine AD patients and 73 controls underwent FDG PET and MRI. The PVE-corrected grey matter PET images were obtained using an MRI-based three-compartment method. Additionally, the results of PET were compared with grey matter loss detected by VBM. Before PVE correction, reduced FDG uptake was observed in posterior cingulate gyri (PCG) and parieto-temporal lobes (PTL) in AD patients, which persisted after PVE correction. Notably, PVE correction revealed relatively preserved FDG uptake in hippocampal areas, despite the grey matter loss in medial temporal lobe (MTL) revealed by VBM. FDG uptake in PCG and PTL is reduced in AD regardless of whether or not PVE correction is applied, supporting the notion that the reduced FDG uptake in these areas is not the result of atrophy. Furthermore, FDG uptake by grey matter tissue in the MTL, including hippocampal areas, is relatively preserved, suggesting that compensatory mechanisms may play a role in patients with mild AD.

Partial-Volume Effect in PET Tumor Imaging

PET has the invaluable advantage of being intrinsically quantitative, enabling accurate measurements of tracer concentrations in vivo. In PET tumor imaging, indices characterizing tumor uptake, such as standardized uptake values, are becoming increasingly important, especially in the context of monitoring the response to therapy. However, when tracer uptake in small tumors is measured, large biases can be introduced by the partial-volume effect (PVE). The purposes of this article are to explain what PVE is and to describe its consequences in PET tumor imaging. The parameters on which PVE depends are reviewed. Actions that can be taken to reduce the errors attributable to PVE are described. Various PVE correction schemes are presented, and their applicability to PET tumor imaging is discussed.

Detecting hippocampal hypometabolism in Mild Cognitive Impairment using automatic voxel-based approaches

While the hippocampus is constantly reported as the site of earliest and highest structural alteration in Alzheimer's disease (AD), findings regarding the metabolic status of this region are rather heterogeneous. It has been proposed that only a time-consuming individual region-of-interest (ROI) approach would allow the detection of hypometabolism in this complex and small area. Our main goal with this study is to assess whether more automatic and clinically useful methods would be sensitive enough when considering other methodological confounds. From a single PET data set collected in 28 patients with amnestic Mild Cognitive Impairment (aMCI) and 19 controls, we assessed the effects of partial volume effect (PVE) correction, scaling (using vermis or global means), and analysis method (individual ROI versus more automatic template-based ROI or voxel-based approaches) on hippocampal hypometabolism detection in aMCI. PVE correction and scaling both showed a significant effect on group comparison, while the analysis method (individual versus template-based ROI) surprisingly did not. Hippocampal metabolic decrease was significant in all vermis-scaled conditions, and more so after PVE correction. Our findings highlight the crucial relevance of using reference-region-based (instead of global) scaling, and the higher sensitivity of PVE-corrected PET measures, to detect hippocampal hypometabolism in aMCI. They also show that hippocampal metabolic decline can be detected using template-based ROI as well as voxel-based methods. These findings have clinical relevance since they support the validity of more automatic and time-saving approaches to assess hippocampal metabolism changes in aMCI and early AD.

A direct ROI quantification method for inherent PVE correction: accuracy assessment in striatal SPECT measurements

The clinical potential of striatal imaging with dopamine transporter (DAT) SPECT tracers is hampered by the limited capability to recover activity concentration ratios due to partial volume effects (PVE). We evaluated the accuracy of a least squares method that allows retrieval of activity in regions of interest directly from projections (LS-ROI). An Alderson striatal phantom was filled with striatal to background ratios of 6:1, 9:1 and 28:1; the striatal and background ROIs were drawn on a coregistered X-ray CT of the phantom. The activity ratios of these ROIs were derived both with the LS-ROI method and with conventional SPECT EM reconstruction (EM-SPECT). Moreover, the two methods were compared in seven patients with motor symptoms who were examined with N-3-fluoropropyl-2-beta-carboxymethoxy-3-beta-(4-iodophenyl) (FP-CIT) SPECT, calculating the binding potential (BP). In the phantom study, the activity ratios obtained with EM-SPECT were 3.5, 5.3 and 17.0, respectively, whereas the LS-ROI method resulted in ratios of 6.2, 9.0 and 27.3, respectively. With the LS-ROI method, the BP in the seven patients was approximately 60% higher than with EM-SPECT; a linear correlation between the LS-ROI and the EM estimates was found (r=0.98, p=0.03). The LS-ROI PVE correction capability is mainly due to the fact that the ill-conditioning of the LS-ROI approach is lower than that of the EM-SPECT one. The LS-ROI seems to be feasible and accurate in the examination of the dopaminergic system. This approach can be fruitful in monitoring of disease progression and in clinical trials of dopaminergic drugs.

Selective neuronal damage and chronic hemodynamic cerebral ischemia

In atherothrombotic internal carotid artery or middle cerebral artery (MCA) occlusive disease, chronic hemodynamic compromise may increase the risk for cerebral ischemic damage. To determine whether selective neuronal damage demonstrated as a decrease in central benzodiazepine receptor (BZR) in the normal-appearing cerebral cortex is associated with increased oxygen extraction fraction (OEF) (misery perfusion). We measured BZR and OEF using positron emission tomography in 105 nondisabled patients with atherothrombotic internal carotid artery or MCA occlusive disease and no cortical infarction. By using three-dimensional stereotactic surface projections and the stereotactic extraction estimation method, without correction for partial volume effects, the abnormally decreased BZR index [(the extent of the pixels with Z-score more than 2 compared with controls) x (average Z-score in those pixels)] in the cerebral cortex of the MCA distribution with arterial disease was calculated, and it was found to be correlated with the mean hemispheric value of OEF and several clinical variables. All patients had pixels with abnormally decreased BZR, with the extent varying from 0.04 to 60.91%. Multivariate analysis showed that the abnormally decreased BZR index was positively correlated with the value of OEF and the history of stroke, whereas it was negatively correlated with the presence of hypercholesterolemia with statin treatment. Follow-up examinations of 17 patients without ischemic episode showed that a decrease of BZR was associated with an increase of OEF. In atherothrombotic internal carotid artery or MCA occlusive disease, misery perfusion may cause selective neuronal damage, and statins might have beneficial effects against neuronal damage.

Apathy correlates with dopamine uptake in neurodegenerative diseases. a spect study with partial volume effect correction

Apathy correlates with dopamine uptake in neurodegenerative diseases. a spect study with partial volume effect correction