Perfusion CT compared to H2 15O/O15O PET in patients with chronic cervical carotid artery occlusion

Amita Kamath, Wade S. Smith, William J. Powers, Alessandro Cianfoni, Jeffrey D. Chien, Tom Videen, Michael T. Lawton, Bruce Finley, William P. Dillon, Max Wintermark

Research output: Contribution to journalArticlepeer-review

46 Scopus citations


Introduction: The purpose of this study was to compare the results of perfusion computed tomography (PCT) with those of 15O 2/H2 15O positron emission tomography (PET) in a subset of Carotid Occlusion Surgery Study (COSS) patients. Materials and methods: Six patients enrolled in the COSS underwent a standard-of-care PCT in addition to the 15O2/H2 15O PET study used for selection for extracranial-intracranial bypass surgery. PCT and PET studies were coregistered and then processed separately by different radiologists. Relative measurement of cerebral blood flow (CBF) and oxygen extraction fraction (OEF) were calculated from PET. PCT datasets were processed using different arterial input functions (AIF). Relative PCT and PET CBF values from matching regions of interest were compared using linear regression model to determine the most appropriate arterial input function for PCT. Also, PCT measurements using the most accurate AIF were evaluated for linear regression with respect to relative PET OEF values. Results: The most accurate PCT relative CBF maps with respect to the gold standard PET CBF were obtained when CBF values for each arterial territory are calculated using a dedicated AIF for each territory (R 2 = 0.796, p < 0.001). PCT mean transit time (MTT) is the parameter that showed the best correlation with the count-based PET OEF ratios (R 2 = 0.590, p < 0.001). Conclusion: PCT relative CBF compares favorably to PET relative CBF in patients with chronic carotid occlusion when processed using a dedicated AIF for each territory. The PCT MTT parameter correlated best with PET relative OEF.

Original languageEnglish
Pages (from-to)745-751
Number of pages7
Issue number9
StatePublished - Sep 2008
Externally publishedYes


  • Arterial input function
  • Chronic carotid occlusion
  • PET
  • Perfusion CT
  • Processing


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