Prognostic value of 99mTc-ECD brain perfusion SPECT in patients with atrial fibrillation and dementia

Abstract Background Patients with atrial fibrillation (AF) and dementia experience reduced quality of life and increased mortality. Technetium 99m ECD brain perfusion single-photon emission computed tomography (99mTc-ECD brain perfusion SPECT) is a beneficial modality for diagnosing dementia and identifying high-risk patients with mild cognitive impairment. The aim of this study was to evaluate the prognostic value of brain perfusion using 99mTc-ECD SPECT in patients with AF and dementia. Methods Of a total of 405 consecutive patients diagnosed with AF as cardiac outpatients with dementia using the Mini-Mental State Examination by neurologists or psychiatrists, we identified 170 patients (81 ± 10 years) who underwent 99mTc-ECD brain perfusion SPECT. Of them, 73, 73, and 24 were diagnosed with Alzheimer’s dementia (AD), vascular dementia (VD), and non-specified dementia, respectively. A multivariable Cox model was used to assess if higher Z-score by 99mTc-ECD brain perfusion SPECT and clinical parameters were associated with major adverse cardiovascular events (MACE) including cardiac death, myocardial infarction, hospitalization for heart failure, and stroke. Results During a mean follow-up of 1258 ± 1044 days, 62 MACE occurred. There was no significant difference in MACE between AD and VD (33%, vs. 44%, p = 0.153). The multivariable Cox model confirmed that the higher Z-score of temporo-parieto-occipital lobe was associated with increased MACE compared to the lower group (HR 2.521, 95% CI 1.465–4.337, p < 0.001). Conclusion This study demonstrated that decreased cerebral blood flow in the temporo-parieto-occipital lobe could be a potential prognostic value in patients with both AF and dementia.

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P175 Prognostic value of 99mTc-ECD brain perfusion SPECT in patients with atrial fibrillation and dementia

European Heart Journal ◽

10.1093/ehjci/ehz872.056 ◽

2020 ◽

Vol 41 (Supplement_1) ◽

Author(s):

H Hashimoto ◽

R Nakanishi ◽

S Mizumura ◽

Y Hashimoto ◽

Y Okamura ◽

...

Keyword(s):

Quality Of Life ◽

Atrial Fibrillation ◽

High Risk ◽

Prognostic Value ◽

Cox Model ◽

Brain Perfusion ◽

Z Score ◽

Brain Perfusion Spect ◽

Perfusion Spect

Abstract Background Atrial fibrillation (AF) is the most common cardiac arrhythmia, and those afflicted have reduced quality of life, functional status, and cardiac performance. The patients with AF have a high risk of coronary heart disease and cardiovascular disease. Although the prevalence of AF is increasing, cognitive disorders are also on the rise in tandem with the aging of the population. The patients with dementia have also experienced lower the quality of life and have increased mortality. Technetium 99m ECD brain perfusion single photon emission computed tomography (99mTc-ECD brain perfusion SPECT) is a useful modality for diagnosing dementia and identifying high risk patients with mild cognitive impairment. However, there are few reports about the relationship between the value of Z score calculated by 99mTc-ECD brain perfusion SPECT and prognosis of patients with AF and dementia. Purpose The aim of this study was to evaluate the prognostic values of brain perfusion using 99mTc-ECD SPECT in patients with AF and dementia. Methods Among 405 consecutive patients who were diagnosed as AF in cardiac outpatients and subsequently diagnosed as dementia using Mini-Mental State Examination by neurologists or psychiatrists, we identified 170 patients (81 ± 10 years) who underwent 99mTc-ECD brain perfusion SPECT for the current study. Of those, 73, 73, and 24 were diagnosed as Alzheimer’s dementia (AD), vascular dementia (VD), and non-specified dementia respectively. Multivariate Cox model was used to assess if higher Z score by 99mTc-ECD brain perfusion SPECT and clinical parameters were associated with major adverse cardiovascular events (MACE) including cardiac death, myocardial infarction, hospitalization for heart failure, and stroke. Sub-analyses of multivariate Cox models by AD or VD were also assessed. The cut-off values of Z score were determined using area under the curve by a receiver operating characteristic analysis based on MACE occurrences. Results During a mean follow-up of 1258 ± 1044 days, 62 MACE occurred. There was not significant difference of MACE between AD and VD (33%, vs. 44%, p = 0.153). By multivariable Cox model, the higher Z score of temporal-occipital-pariental lobe was associated with increased MACE compared to the lower group (HR 2.521, 95% CI 1.465–4.337, p < 0.001). In a sub-analysis of patients with AD, Z score was the most significant prognostic factor for MACE (HR 3.969, 95% CI 1.374–11.468, p = 0.011). The similar trend was observed in those with VD (HR 2.247, 95% CI 1.028–4.913, p = 0.043). Conclusion: This study demonstrated that the Z score of temporal-occipital-pariental lobe by 99mTc-ECD brain perfusion SPECT could be a potential prognostic value among patients with AF and dementia, regardless of type of dementia.

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Prognostic value of brain perfusion single-photon emission computed tomography (SPECT) for language recovery in patients with aphasia

Nuclear Medicine Communications ◽

10.1097/00006231-200510000-00011 ◽

2005 ◽

Vol 26 (10) ◽

pp. 919-923 ◽

Cited By ~ 4

Author(s):

Tassei Nakagawa ◽

Yuji Murata ◽

Tomoyuki Kojima ◽

Yasuhisa Shinkai ◽

Yoko Yamaya ◽

...

Keyword(s):

Computed Tomography ◽

Prognostic Value ◽

Single Photon ◽

Photon Emission ◽

Brain Perfusion ◽

Emission Computed Tomography ◽

Single Photon Emission ◽

Language Recovery ◽

Single Photon Emission Computed ◽

Photon Emission Computed Tomography

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The role of cognitive group therapy and happiness training on cerebral blood flow using 99mTc-ECD brain perfusion SPECT

Nuklearmedizin ◽

10.3413/nukmed-0632-13-11 ◽

2014 ◽

Vol 53 (05) ◽

pp. 205-210

Author(s):

M. Azizi ◽

S. A. Bahrieniain ◽

A. Baghdasarians ◽

S. Emamipur ◽

Z. Azizmohammadi ◽

...

Keyword(s):

Blood Flow ◽

Cerebral Blood Flow ◽

Group Therapy ◽

Brain Perfusion ◽

Control Group ◽

Brain Perfusion Spect ◽

Significant Difference ◽

Before And After ◽

Perfusion Spect ◽

The Impact

Summary Objective: The purpose of this study is to investigate the impact of cognitive group therapy and happiness training objectively in the local cerebral blood flow of patients with major depression (MD). Patients, material, methods: The present research is semi-experimental to pre- and post-test with a control group. Three groups were formed, and this number was incorporated in each group: 12 patients were chosen randomly; the first group of depressed patients benefited from the combination of pharmacotherapy and sessions of cognitive group therapy; the second group used a combination of pharmaco- therapy and sessions of happiness training; and a third group used only pharmacother- apy. We compared cognitive-behavioural therapy and happiness training efficacy with only pharmacotherapy in MD patients. We performed brain perfusion SPECT in each group, before and after each trial. Results: The study was conducted on 36 patients with MD (32 women and 4 men; mean age: 41.22 ± 9.08; range: 27-65 years). There were significant differences regarding the two trial effects into two experimental groups (p < 0/001) before and after trials, while such differences were not significant in the control group (p > 0.05). In addition, there was significant difference among the regional cerebral blood flow in the frontal and prefrontal regions into two experimental groups before and after trials (p < 0/001), while such differences were not significant in the control group (p > 0.05). Conclusion: This study demonstrated decreased cerebral perfusion in the frontal regions in MD patients, which increased following cognitive group therapy and happiness training. Because of its availability, low costs, easy performance, and the objective semi-quantitative information supplied, brain perfusion SPECT

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Reduced Hypoxic Tissue and Cognitive Improvement after Revascularization Surgery for Chronic Cerebral Ischemia

Cerebrovascular Diseases ◽

10.1159/000497244 ◽

2019 ◽

Vol 47 (1-2) ◽

pp. 57-64 ◽

Cited By ~ 3

Author(s):

Yasuyoshi Shimada ◽

Masakazu Kobayashi ◽

Kenji Yoshida ◽

Kazunori Terasaki ◽

Shunrou Fujiwara ◽

...

Keyword(s):

Cerebral Ischemia ◽

Cerebral Perfusion ◽

Brain Perfusion ◽

Emission Computed Tomography ◽

Chronic Cerebral Ischemia ◽

Brain Perfusion Spect ◽

Cognitive Improvement ◽

Perfusion Spect ◽

The Difference ◽

Revascularization Surgery

Background: Hypoxic but viable neural tissue is seen on 1-(2–18F-fluoro-1-[hydroxymethyl]ethoxy) methyl-2-nitroimidazole (18F-FRP170) positron emission tomography (PET) in patients with chronic cerebral ischemia with a combination of misery perfusion and moderately reduced oxygen metabolism. Cognitive function sometimes improves after revascularization surgery in patients with chronic cerebral ischemia. Objectives: We used brain perfusion single-photon emission computed tomography (SPECT) and 18F-FRP170 PET to determine whether hypoxic tissue was reduced following the restoration of cerebral perfusion after carotid endarterectomy (CEA) in patients with severe stenosis of the cervical internal carotid artery (ICA) and whether the reduction in hypoxic tissue was associated with cognitive improvement. Method: Eighteen patients with abnormally reduced cerebral blood flow (CBF) in the affected cerebral hemispheres on preoperative brain perfusion SPECT underwent CEA. They underwent 18F-FRP170 PET and neuropsychological tests preoperatively and 6 months postoperatively. Brain perfusion SPECT was also performed 6 months postoperatively. Regions of interest were placed in the bilateral middle cerebral artery territories on SPECT and PET images, and the ratio of values in the affected versus contralateral hemispheres was calculated. Results: The CBF ratio (p = 0.0006) and 18F-FRP170 ratio (p = 0.0084) were significantly increased and reduced, respectively, after surgery compared to the corresponding ratios before surgery. The difference in the 18F-FRP170 ratio (postoperative – preoperative value) was negatively correlated with the difference in the CBF ratio (ρ = –0.695; p = 0.0009). The difference in the 18F-FRP170 ratio was significantly lower in patients with postoperative improved cognition compared to that in those without (p = 0.0007). The area under the receiver operating characteristics curve for the difference in the 18F-FRP170 ratio for detecting postoperative improved cognition was significantly greater than that for the difference in the CBF ratio (difference between areas, 0.278; p = 0.0248). Conclusions: Hypoxic tissue is reduced following the restoration of cerebral perfusion with revascularization surgery in patients with severe atherosclerotic stenosis of the cervical ICA. The reduction in hypoxic tissue is associated with cognitive improvement in such patients.

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Brain perfusion SPECT and MRI in foetal alcohol syndrome

Developmental Medicine & Child Neurology ◽

10.1017/s0012162299001358 ◽

1999 ◽

Vol 41 (10) ◽

pp. 652-659 ◽

Cited By ~ 101

Author(s):

R Riikonen ◽

I Salonen ◽

K Partanen ◽

S Verho

Keyword(s):

Brain Perfusion ◽

Brain Perfusion Spect ◽

Foetal Alcohol Syndrome ◽

Perfusion Spect

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High-quality brain perfusion SPECT images may be achieved with a high-speed recording using 360° CZT camera

EJNMMI Physics ◽

10.1186/s40658-020-00334-7 ◽

2020 ◽

Vol 7 (1) ◽

Author(s):

Manon Bordonne ◽

Mohammad B. Chawki ◽

Pierre-Yves Marie ◽

Timothée Zaragori ◽

Véronique Roch ◽

...

Keyword(s):

Image Quality ◽

High Speed ◽

Brain Perfusion ◽

Fold Increase ◽

Brain Structures ◽

Czt Camera ◽

Recording Time ◽

Brain Perfusion Spect ◽

Central Brain ◽

Perfusion Spect

Abstract Objective The aim of this study was to compare brain perfusion SPECT obtained from a 360° CZT and a conventional Anger camera. Methods The 360° CZT camera utilizing a brain configuration, with 12 detectors surrounding the head, was compared to a 2-head Anger camera for count sensitivity and image quality on 30-min SPECT recordings from a brain phantom and from 99mTc-HMPAO brain perfusion in 2 groups of 21 patients investigated with the CZT and Anger cameras, respectively. Image reconstruction was adjusted according to image contrast for each camera. Results The CZT camera provided more than 2-fold increase in count sensitivity, as compared with the Anger camera, as well as (1) lower sharpness indexes, giving evidence of higher spatial resolution, for both peripheral/central brain structures, with respective median values of 5.2%/3.7% versus 2.4%/1.9% for CZT and Anger camera respectively in patients (p < 0.01), and 8.0%/6.9% versus 6.2%/3.7% on phantom; and (2) higher gray/white matter contrast on peripheral/central structures, with respective ratio median values of 1.56/1.35 versus 1.11/1.20 for CZT and Anger camera respectively in patients (p < 0.05), and 2.57/2.17 versus 1.40/1.12 on phantom; and (3) no change in noise level. Image quality, scored visually by experienced physicians, was also significantly higher on CZT than on the Anger camera (+ 80%, p < 0.01), and all these results were unchanged on the CZT images obtained with only a 15 min recording time. Conclusion The 360° CZT camera provides brain perfusion images of much higher quality than a conventional Anger camera, even with high-speed recordings, thus demonstrating the potential for repositioning brain perfusion SPECT to the forefront of brain imaging.

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