A consistent method for the qualitative analysis of regional cerebral blood flow on single-photon emission computed tomography (SPECT) Imaging has not yet been realized. Regional analysis usually refers an area of abnormal tracer uptake to another region of brain (e.g., the contralateral hemisphere), but region of interest size and analysis differ between Investigators. In patients who have had a stroke, the flow deficit size on the SPECT Image often appears much larger than the abnormality visualized on computed tomography (CT), and confounds attempts to differentiate between “purely” Infarcted brain tissue, ischemic brain tissue, edema, or brain tissue having diminution of flow resulting from deafferentation. The author presents a method to determine a flow deficit volume that can be easlly calculated from the SPECT Image, which yields a volume size that is equivalent to a hypothetical volume having zero blood flow. The method of calculation is objective, independent of region of interest size, and provides a SPECT volume deficit that may be correlated with the CT volume deficit, thus helping to differentiate “purely” infarcted tissue from tissue having Infarction, edema, Ischemia, and deafferentation.
From the Department of Internal Medicine, Division of Nuclear Medicine, Ann Arbor, Michigan