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Original research
X-ray angiography perfusion imaging with an intra-arterial injection: comparative study with 15O-gas/water positron emission tomography
  1. Katsunori Asai1,
  2. Hajime Nakamura1,
  3. Tadashi Watabe2,
  4. Takeo Nishida1,
  5. Manabu Sakaguchi3,
  6. Jun Hatazawa2,
  7. Toshiki Yoshimine4,
  8. Haruhiko Kishima1
  1. 1Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
  2. 2Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Suita, Japan
  3. 3Stroke Division, Department of Neurology, Osaka University Graduate School of Medicine, Suita, Japan
  4. 4Division of Clinical Neuroengineering, Global Center for Medical Engineering and Informatics, Osaka University, Suita, Japan
  1. Correspondence to Dr Hajime Nakamura, Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Osaka, 5650871, Japan; hajime{at}nsurg.med.osaka-u.ac.jp

Abstract

Background X-ray angiography perfusion (XAP) is a perfusion imaging technique based on conventional DSA.

Objective In this study, we aimed to validate parameters derived from XAP by comparing them with 15O-gas/water positron emission tomography (PET), using data from patients with chronic ischemic cerebrovascular disease.

Methods 18 consecutive patients were included. XAP was performed with intra-arterial infusion of contrast media, and a time–density curve was constructed for each cerebral hemisphere. From the curves, the relative values of mean transit time (rMTT) and wash-in rate (rWiR) were obtained by dividing the values of the right hemisphere by those of the left hemisphere. These were then compared with the relative values of cerebral blood flow (rCBF) and rMTT calculated from the PET data.

Results XAP rWiR correlated strongly with PET rCBF (r=0.86, P<0.0001). rMTT measurements from the two modalities were also strongly correlated (r=0.85, P<0.0001). Bland–Altman analysis revealed a bias of 0.14±0.18 (95% limits of agreement −0.22 to 0.51) for PET rCBF versus XAP rWiR, and 0.016±0.093 (95% limits of agreement −0.17 to 0.20) for rMTT between the two modalities.

Conclusions The relative values obtained from XAP were validated across a population of patients with chronic ischemic cerebrovascular disease.

  • angiography
  • blood flow
  • stenosis
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Footnotes

  • Contributors Concept and study design: KA, HN, JH, HK and TY. Data acquisition and analysis: KA, TW, HN, TN, and MS. Drafting of the manuscript and figures: KA, TW, and HN. Review and editing of the manuscript: all authors.

  • Funding This work was supported by the Osaka Medical Research Foundation for Intractable Diseases, grant No 23-2-2.

  • Competing interests None declared.

  • Ethics approval The study was approved by the ethics committee of the institutional review board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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