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Shorter Examination Method for the Diagnosis of Misery Perfusion with Count-Based Oxygen Extraction Fraction Elevation in ¹⁵O-Gas PET

¹ Biomedical Imaging Research Center, University of Fukui, Fukui, Japan; and ² Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Fukui, Japan

View larger version (11K): [in this window] [in a new window]   FIGURE 1.  Scan protocol and data preparation for 15O-gas PET. For cbOEF calculation, subsets of 15O2 dynamic data were extracted at 2, 3, 4, 5, 6, and 7 min (bars below diagram, from top to bottom, respectively) after beginning of 15O2 inhalation up to 13 min. cbOEF-AI was calculated from 15O2 images and H215O PET scans for 3 min. qOEF was calculated from 15O2 images obtained from 8 min to 13 min after 15O2 inhalation and H215O images with arterial blood data. C15O data were used for CBV correction of qOEF.

View larger version (14K): [in this window] [in a new window]   FIGURE 2.  Changes in cbOEF-AI for 3 patients with misery perfusion, as determined from 15O2 images with various scan durations started at 2 min (A), 3 min (B), 4 min (C), and 5 min (D) after beginning of 15O2 inhalation. Misery perfusion was defined in our previous study as increase in qOEF of 52.0% or greater, which is equivalent to threshold of 1.17 for qOEF-AI (qOEF-AI = 1.17 for • and and 1.36 for ). Threshold of 1.15 for cbOEF-AI in present study (dashed line) was equivalent to threshold of 1.17 for qOEF-AI in our previous study. Regardless of different acquisition start times, continuous 15O2 inhalation for 7 min or longer would be required to correctly detect misery perfusion.