Hypoxic Viable Tissue in Human Chronic Cerebral Ischemia Because of Unilateral Major Cerebral Artery Steno-Occlusive Disease. Issue 5 (May 2015)

• Record Type: Journal Article
• Authors: Saura, Hiroaki; Ogasawara, Kuniaki; Beppu, Takaaki; Yoshida, Koji; Kobayashi, Masakazu; Yoshida, Kenji; Terasaki, Kazunori; Takai, Yoshihiro; Ogawa, Akira
• Is Part Of: Stroke. Volume 46:Issue 5(2015)
• Publication Date: 2015-05
• Subjects: Cerebrovascular disease -- Periodicals; Cerebral circulation -- Periodicals; 616.81
• DOI: 10.1161/STROKEAHA.114.008238
• Languages: English
• ISSNs: 0039-2499

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Background and Purpose—</title> <p>Positron emission tomography (PET) with radiolabeled 2-nitroimidazoles directly detects hypoxic but viable tissue present in an acute ischemic area in the human brain. This study using PET with 1-(2-<sup>18</sup>F-fluoro-1-[hydroxymethyl]ethoxy) methyl-2-nitroimidazole (<sup>18</sup>F-FRP170) aimed to determine whether tissue with an abnormally elevated uptake of <sup>18</sup>F-FRP170 exists in human chronic cerebral ischemia because of unilateral atherosclerotic major cerebral artery steno-occlusive disease.</p> </sec> <sec> <title>Methods—</title> <p> <sup>18</sup>F-FRP170 PET was performed, and cerebral blood flow and metabolism were assessed using <sup>15</sup>O-gas PET in 20 healthy subjects and 52 patients. A region of interest (ROI) was automatically placed in 3 segments of the middle cerebral artery territory in both cerebral hemispheres with a 3-dimensional stereotaxic ROI template using SPM2, and each PET value was determined in each ROI. The ratio of values in the affected versus contralateral hemispheres was calculated for the <sup>18</sup>F-FRP170 PET image.</p> </sec> <sec> <title>Results—</title> <p>A significant correlation was observed between oxygen extraction fraction and <sup>18</sup>F-FRP170 ratios (<italic>ρ</italic>=0.509; <italic>P</italic><0.0001) in a total of 156 ROIs in 52 patients. The specificity and positive-predictive value for a combination of an elevated oxygen extraction fraction and a moderately reduced cerebral oxygen metabolism for detection of an abnormally elevated <sup>18</sup>F-FRP170 ratio (19 ROIs: 12%) were significantly greater than those for the individual categories (elevated oxygen extraction fraction, moderately reduced cerebral oxygen metabolism, or reduced cerebral blood flow).</p> </sec> <sec> <title>Conclusions—</title> <p>Tissues with abnormally elevated uptake of <sup>18</sup>F-FRP170 exist in human chronic cerebral ischemia characterized by a combination of misery perfusion and moderately reduced oxygen metabolism because of unilateral atherosclerotic major cerebral artery steno-occlusive disease.</p> </sec> </abstract>