Post traumatic brain perfusion SPECT analysis using reconstructed ROI maps of radioactive microsphere derived cerebral blood flow and statistical parametric mapping

Anthony J McGoron¹ , Michael Capille¹ , Michael F Georgiou² , Pablo Sanchez² , Juan Solano³ , Manuel Gonzalez-Brito³ and John W Kuluz³

¹Department of Biomedical Engineering, Florida International University, 10555 West Flagler Street, EC 2671, Miami FL, 33199, USA

²Department of Radiology, Division of Nuclear Medicine (D57), University of Miami, P.O Box 016960, Miami, FL 33101, USA

³Department of Pediatrics, Division of Critical Care Medicine (R-131), University of Miami, P.O Box 016960, Miami, FL 33101, USA

author email corresponding author email

BMC Medical Imaging 2008, 8:4doi:10.1186/1471-2342-8-4


Published:	29 February 2008

Abstract

Background

Assessment of cerebral blood flow (CBF) by SPECT could be important in the management of patients with severe traumatic brain injury (TBI) because changes in regional CBF can affect outcome by promoting edema formation and intracranial pressure elevation (with cerebral hyperemia), or by causing secondary ischemic injury including post-traumatic stroke. The purpose of this study was to establish an improved method for evaluating regional CBF changes after TBI in piglets.

Methods

The focal effects of moderate traumatic brain injury (TBI) on cerebral blood flow (CBF) by SPECT cerebral blood perfusion (CBP) imaging in an animal model were investigated by parallelized statistical techniques. Regional CBF was measured by radioactive microspheres and by SPECT 2 hours after injury in sham-operated piglets versus those receiving severe TBI by fluid-percussion injury to the left parietal lobe. Qualitative SPECT CBP accuracy was assessed against reference radioactive microsphere regional CBF measurements by map reconstruction, registration and smoothing. Cerebral hypoperfusion in the test group was identified at the voxel level using statistical parametric mapping (SPM).

Results

A significant area of hypoperfusion (P < 0.01) was found as a response to the TBI. Statistical mapping of the reference microsphere CBF data confirms a focal decrease found with SPECT and SPM.

Conclusion

The suitability of SPM for application to the experimental model and ability to provide insight into CBF changes in response to traumatic injury was validated by the SPECT SPM result of a decrease in CBP at the left parietal region injury area of the test group. Further study and correlation of this characteristic lesion with long-term outcomes and auxiliary diagnostic modalities is critical to developing more effective critical care treatment guidelines and automated medical imaging processing techniques.