PT  - JOURNAL ARTICLE
AU  - Güliz Acker
AU  - Catharina Lange
AU  - Imke Schatka
AU  - Andreas Pfeifer
AU  - Marcus A. Czabanka
AU  - Peter Vajkoczy
AU  - Ralph Buchert
TI  - Brain Perfusion Imaging Under Acetazolamide Challenge for Detection of Impaired Cerebrovascular Reserve Capacity: Positive Findings with <sup>15</sup>O-Water PET in Patients with Negative <sup>99m</sup>Tc-HMPAO SPECT Findings
AID  - 10.2967/jnumed.117.195818
DP  - 2018 Feb 01
TA  - Journal of Nuclear Medicine
PG  - 294--298
VI  - 59
IP  - 2
4099  - http://jnm.snmjournals.org/content/59/2/294.short
4100  - http://jnm.snmjournals.org/content/59/2/294.full
SO  - J Nucl Med2018 Feb 01; 59
AB  - Cerebrovascular reserve capacity (CVRC) is an important parameter for treatment decisions in chronic cerebrovascular diseases. It can be assessed by measuring the acetazolamide-induced change in regional cerebral blood flow using SPECT with 99mTc-labeled hexamethylpropyleneamine oxime (99mTc-HMPAO) or PET with 15O-water. Methods: Our database was searched for patients with moyamoya vasculopathy or atherosclerotic cerebrovascular disease who had undergone 15O-water PET after normal 99mTc-HMPAO SPECT results with respect to CVRC. 15O-water PET was analyzed visually and quantitatively. Quantitative analysis was based on parametric CVRC maps generated by voxelwise image subtraction. Results: The search identified 18 patients (43 ± 15 y, 12 moyamoya vasculopathy). PET revealed impaired CVRC in 8 patients (44%). Quantitative analysis confirmed the positive visual findings in 15O-water PET and the negative findings in 99mTc-HMPAO SPECT. Conclusion: 15O-water PET enables detection of impaired CVRC in a considerable fraction of symptomatic patients with stenoocclusion and negative 99mTc-HMPAO SPECT.