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European Journal of Nuclear Medicine and Molecular Imaging

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Open Access 01-07-2020 | Positron Emission Tomography | Original Article

Simultaneous PET-MRI imaging of cerebral blood flow and glucose metabolism in the symptomatic unilateral internal carotid artery/middle cerebral artery steno-occlusive disease

Authors: Bixiao Cui, Tianhao Zhang, Yan Ma, Zhongwei Chen, Jie Ma, Lei Ma, Liqun Jiao, Yun Zhou, Baoci Shan, Jie Lu

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 7/2020

Abstract

Purpose

Cerebral blood flow (CBF) and glucose metabolism are important and significant factors in ischaemic cerebrovascular disease. The objective of this study was to use quantitative hybrid PET/MR to evaluate the effects of surgery treatment on the symptomatic unilateral internal carotid artery/middle cerebral artery steno-occlusive disease.

Methods

Fifteen patients diagnosed with ischaemic cerebrovascular disease were evaluated using a hybrid TOF PET/MR system (Signa, GE Healthcare). The CBF value measured by arterial spin labelling (ASL) and the standardized uptake value ratio (SUVR) measured by ¹⁸F-FDG PET were obtained, except for the infarct area and its contralateral side, before and after bypass surgery. The asymmetry index (AI) was calculated from the CBF and SUVR of the ipsilateral and contralateral cerebral hemispheres, respectively. The ΔCBF and ΔSUVR were calculated as the percent changes of CBF and SUVR between before and after surgery, and paired t tests were used to determine whether a significant change occurred. Spearman’s rank correlation was also used to compare CBF with glucose metabolism in the same region.

Results

The analysis primarily revealed that after bypass surgery, a statistically significant increase occurred in the CBF on the affected side (P < 0.01). The postprocedural SUVR was not significantly higher than the preprocedural SUVR (P > 0.05). However, the postprocedural AI values for CBF and SUVR were significantly lower after surgery than before surgery (P < 0.01). A significant correlation was found between the AI values for preoperative CBF and SUVR on the ipsilateral hemisphere (P < 0.01).

Conclusions

The present study demonstrates that a combination of ASL and ¹⁸F-FDG PET could be used to simultaneously analyse changes in patients’ cerebral haemodynamic patterns and metabolism between before and after superficial temporal artery-middle cerebral artery (STA-MCA) bypass surgery. This therefore represents an essential tool for the evaluation of critical haemodynamic and metabolic status in patients with symptomatic unilateral ischaemic cerebrovascular disease.

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Title: Simultaneous PET-MRI imaging of cerebral blood flow and glucose metabolism in the symptomatic unilateral internal carotid artery/middle cerebral artery steno-occlusive disease
Authors: Bixiao Cui
Tianhao Zhang
Yan Ma
Zhongwei Chen
Jie Ma
Lei Ma
Liqun Jiao
Yun Zhou
Baoci Shan
Jie Lu
Publication date: 01-07-2020
Publisher: Springer Berlin Heidelberg
Keyword: Positron Emission Tomography
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 7/2020
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-019-04551-w

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Simultaneous PET-MRI imaging of cerebral blood flow and glucose metabolism in the symptomatic unilateral internal carotid artery/middle cerebral artery steno-occlusive disease

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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