Basal and Acetazolamide Brain Perfusion SPECT in Internal Carotid Artery Stenosis View Full Text


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Article Info

DATE

2020-01-08

AUTHORS

Teck Huat Wong, Qaid Ahmed Shagera, Hyun Gee Ryoo, Seunggyun Ha, Dong Soo Lee

ABSTRACT

Internal carotid artery (ICA) stenosis including Moyamoya disease needs revascularization when hemodynamic insufficiency is validated. Vascular reserve impairment was the key to find the indication for endarterectomy/bypass surgery in the atherosclerotic ICA stenosis and to determine the indication, treatment effect, and prognosis in Moyamoya diseases. Vascular reserve was quantitatively assessed by 1-day split-dose I-123 IMP basal/acetazolamide SPECT in Japan or by Tc-99m HMPAO SPECT in other countries using qualitative or semi-quantitative method. We summarized the development of 1-day basal/ acetazolamide brain perfusion SPECT for ICA stenosis, both quantitative and qualitative methods, and their methodological issues regarding (1) acquisition protocol; (2) qualitative assessment, either visual or deep learning-based; (3) clinical use for atherosclerotic ICA steno-occlusive diseases and mostly Moyamoya diseases; and (4) their impact on the choice of treatment options. Trials to use CT perfusion or perfusion MRI using contrast materials or arterial spin labeling were briefly discussed in their endeavor to use basal studies alone to replace acetazolamide-challenge SPECT. Theoretical and practical issues imply that basal perfusion evaluation, no matter how much sophisticated, will not disclose vascular reserve. Acetazolamide rarely causes serious adverse reactions but included fatality, and now, we need to monitor patients closely in acetazolamide-challenge studies. More... »

PAGES

9-27

References to SciGraph publications

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  • 2016-05-04. Long-term patency of superficial temporal artery to middle cerebral artery bypass for cerebral atherosclerotic disease: factors determining the bypass patent in NEUROSURGICAL REVIEW
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s13139-019-00633-7

    DOI

    http://dx.doi.org/10.1007/s13139-019-00633-7

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1123951945

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/32206127


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    29 schema:description Internal carotid artery (ICA) stenosis including Moyamoya disease needs revascularization when hemodynamic insufficiency is validated. Vascular reserve impairment was the key to find the indication for endarterectomy/bypass surgery in the atherosclerotic ICA stenosis and to determine the indication, treatment effect, and prognosis in Moyamoya diseases. Vascular reserve was quantitatively assessed by 1-day split-dose I-123 IMP basal/acetazolamide SPECT in Japan or by Tc-99m HMPAO SPECT in other countries using qualitative or semi-quantitative method. We summarized the development of 1-day basal/ acetazolamide brain perfusion SPECT for ICA stenosis, both quantitative and qualitative methods, and their methodological issues regarding (1) acquisition protocol; (2) qualitative assessment, either visual or deep learning-based; (3) clinical use for atherosclerotic ICA steno-occlusive diseases and mostly Moyamoya diseases; and (4) their impact on the choice of treatment options. Trials to use CT perfusion or perfusion MRI using contrast materials or arterial spin labeling were briefly discussed in their endeavor to use basal studies alone to replace acetazolamide-challenge SPECT. Theoretical and practical issues imply that basal perfusion evaluation, no matter how much sophisticated, will not disclose vascular reserve. Acetazolamide rarely causes serious adverse reactions but included fatality, and now, we need to monitor patients closely in acetazolamide-challenge studies.
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    37 ICA stenosis
    38 Japan
    39 MRI
    40 SPECT
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    52 bypass surgery
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    54 choice
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    57 countries
    58 development
    59 disease
    60 effect
    61 endeavor
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    63 fatalities
    64 hemodynamic insufficiency
    65 impact
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    67 indications
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    69 internal carotid artery stenosis
    70 issues
    71 key
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    73 materials
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