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Voxel-Based Correlation Between Whole-Brain CT Perfusion With 320-Row Area Detector CT and Iodine 123 Iodoamphetamine Brain Perfusion SPECT in Patients With Cerebrovascular Disease

Murayama, Kazuhiro MD, PhD*; Toyama, Hiroshi MD, PhD*; Hayakawa, Motoharu MD, PhD; Imizu, Shuei MD, PhD; Soma, Tsutomu MSc; Taniguchi, Akira BSc, RT§; Katada, Kazuhiro MD, PhD

Journal of Computer Assisted Tomography: September/October 2014 - Volume 38 - Issue 5 - p 639–646
doi: 10.1097/RCT.0000000000000110

Objective We compared cerebral blood flow (CBF) measured using computed tomographic (CT) perfusion (CTP) and N-isopropyl-p-[(123) I]-iodoamphetamine cerebral perfusion single-photon emission computed tomography (SPECT).

Methods We used a 320-row area detector CT and N-isopropyl-p-[(123) I]-iodoamphetamine cerebral perfusion SPECT under similar conditions in patients with chronic cerebrovascular disease. Images were automatically aligned 3-dimensionally for voxel-by-voxel comparisons.

Results Linear positive correlations were observed between CTP-CBF including high-blood-flow areas and SPECT-CBF over the whole brain (r = 0.001–0.6, P < 0.01), superior cerebral level (r = 0.45–0.93, P < 0.01), basal ganglia level (r = 0.44–0.77, P < 0.01), and skull base (r = 0.02–0.66, P < 0.01). Correlations between CTP-CBF excluding high-blood-flow areas were significantly higher (P < 0.0001).

Conclusions Computed tomographic perfusion overestimated CBF compared with SPECT and showed poor correlation at the skull base. Computed tomographic perfusion CTP excluding high-blood-flow areas improved the correlation over the whole brain in patients with chronic cerebrovascular disease.

From the *Department of Radiology and †Neurosurgery, Fujita Health University, Toyoake, Japan; ‡Division of Nuclear Medicine, Graduate School of Medicine, University of Tokyo, Japan; Software Development Group, Product Management and Marketing Department., Sales and Marketing Division, FUJIFILM RI Pharma Co., Ltd., Japan; §Clinical Application Research Center, Toshiba Medical Systems Corporation, Otawara, Japan; and ∥Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University, Toyoake, Japan.

Received for publication January 8, 2014; accepted April 3, 2014.

Reprints: Kazuhiro Murayama, MD, PhD, Department of Radiology, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho Toyoake, Aichi, 470–1101, Japan (e-mail:

KM has grant support from Toshiba Medical Systems Corporation. The remaining authors declare no conflict of interest.

© 2014 by Lippincott Williams & Wilkins