Cerebral glucose metabolism changes in chronic ischemia patients following subcranial-intracranial bypass

Yu, Zaitao; Shi, Xiaoyan; Zhou, Zhongqing; Yang, Yang; Li, Pengbo; Zhang, Yuqi

doi:10.1007/s10143-019-01177-2

Cited by 6 publications

(3 citation statements)

References 18 publications

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“…In our previous study, 15 patients demonstrated improved glucose metabolism on 18 F-FDG PET/MR after bypass surgery [ 10 ]. Yu et al [ 8 ] performed a serial PET study in which 18 F-FDG was used to investigate changes in glucose metabolism before and after bypass surgery and found that the uptake of 18 F-FDG in the hypoperfusion region surrounding the ischemic core was a sensitive indicator for predicting ischemia. The present study retrospectively analyzed glucose metabolic alterations between CCD + and CCD− groups before bypass surgery.…”

Section: Discussionmentioning

confidence: 99%

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Crossed cerebellar diaschisis-related supratentorial hemodynamic and metabolic status measured by PET/MR in assessing postoperative prognosis in chronic ischemic cerebrovascular disease patients with bypass surgery

et al. 2022

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Objective Cerebral ischemic status is an indicator of bypass surgery. Both hemodynamics and glucose metabolism are significant factors for evaluating cerebral ischemic status. The occurrence of crossed cerebellar diaschisis (CCD) is influenced by the degree of supra-tentorial perfusion and glucose metabolism reduction. This study aimed to investigate the relationship between the CCD-related supra-tentorial blood flow and metabolic status before bypass surgery in patients with chronic and symptomatic ischemic cerebrovascular disease and the prognosis of surgery. Methods Twenty-four participants with chronic ischemic cerebrovascular disease who underwent hybrid positron emission tomography (PET)/magnetic resonance (MR) before bypass surgery were included. Arterial spin labeling (ASL)-MR and FDG-PET were used to measure blood flow and metabolism, respectively. The PET images were able to distinguish CCD. The supratentorial asymmetry index (AI) and volume in the decreased blood flow region, decreased metabolism region and co-decreased region on the affected side, except for the infarct area, were respectively obtained before bypass surgery. The neurological status was determined using the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) scores. Differences between CCD-positive (CCD +) and CCD-negative (CCD−) groups were investigated. Results Fourteen (58%) of the 24 patients were diagnosed as CCD +. Before surgery, the NIHSS and mRS scores of the CCD + were significantly higher than those of the CCD− (1.0(1.0) vs. 0.0(1.0), P = 0.013; 1.0(1.5) vs. 0.0(1.5), P = 0.048). After the surgery, the NIHSS and mRS scores of the CCD + showed a significant decrease (0.0(1.0) to 0.0(0.0), P = 0.011; 0.0(0.5) to 0.0(0.0), P = 0.008). Significant differences were observed in the supra-tentorial decreased metabolism region (all Ps ≤ 0.05) between the CCD + and CCD− groups, but no differences were observed in the preprocedural decreased supratentorial blood flow region (P > 0.05). The preprocedural NIHSS score was strongly correlated with the metabolism AI value in the decreased metabolism region (r = 0.621, P = 0.001) and the co-decreased region (r = 0.571, P = 0.004). Conclusions Supratentorial blood flow and metabolism are important indicators of CCD. This study showed that CCD + patients benefited more from bypass surgery than CCD− patients. Staging based on CCD-related supra-tentorial blood flow and metabolic status by hybrid PET/MR may help to personalize treatment.

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Section: Discussionmentioning

confidence: 99%

“…Cerebral ischemic status is an indicator of surgery. Hemodynamics and glucose metabolism are significant factors for evaluating cerebral ischemic status [5][6][7][8]. The Carotid Occlusion Surgery Study (COSS) in 2011 failed to show a clear benefit of bypass surgery in patients compared to conservative drug therapy [9].…”

Section: Introductionmentioning

confidence: 99%

Crossed cerebellar diaschisis-related supratentorial hemodynamic and metabolic status measured by PET/MR in assessing postoperative prognosis in chronic ischemic cerebrovascular disease patients with bypass surgery

et al. 2022

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“…Previous study showed that SUV value in the ischemic hemisphere could be sensitive sensitive indicator for predicting ischemia, but not only the ipsilateral SUV value but also the contralateral SUV value showed changes after surgery treatment in 1 month [35]. Moreover, the application of SUVR may be blind to the metabolism changes in the ipsilateral cerebellum region (BA territory) because of the reference region.…”

Section: Discussionmentioning

confidence: 99%

A Noninvasive Quantification Approach for Monitoring Brain Metabolic Alterations After Surgical Intervention in Ischemic Cerebrovascular Disease

Wang

Cui

Shan

et al. 2021

Preprint

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Purpose: Non-invasive quantification of cerebral metabolic rate for glucose (CMRGlc) and characterizing cerebral metabolism of cerebrovascular territories are useful for the understanding of ischemic cerebrovascular disease (ICVD). Here, we proposed a non-invasive quantification approach based on image-derived input function (IDIF) suitable for ICVD patients and monitored the pathophysiological changes after surgical intervention.Methods: Sixteen healthy controls and 26 ischemic cerebrovascular disease patients with baseline and after surgical visits underwent 18F-FDG PET/MR imaging. The voxel-wise CMRGlc maps were derived via our proposed IDIF method. The CMRGlc and standardized uptake value ratio (SUVR) maps were subsequently used to extract quantitative values within 7 volumes of interest (gray matter, white matter, anterior, middle, and posterior cerebral artery, basilar artery, and cerebellar artery territory). Intraclass correlation coefficient (ICC) and absolute percentage error were employed to measure consistency in healthy controls. The quantitative differences of healthy controls and patients at baseline and after surgical visits were statistically analyzed. Results: For healthy controls, there were no significant differences for region CMRGlc values across bilateral and unilateral IDIF measurements (ICC: 0.91-0.98). Significant differences in CMRGlc were observed across the cohorts in all territories (P< 0.001). The CMRGlc values in the ipsilateral side were significantly increased after surgery intervention (P < 0.05) for all territories (percentage changes: 7.4%~22.5%). Only the posterior cerebral artery and basilar artery territories (-2.8% and 1.9%) were significant differences for SUVR (P < 0.05). The diagnostic ability of CMRGlc in various territories (area under curve: 0.923-0.966) was significantly higher than of SUVR. There was a significant association between CMRGlc with the national institutes of health stroke scores (r: -0.54, P = 0.0041).Conclusion: These observations suggested the non-invasive quantification approach based on IDIF allowed the individual metabolism measurement of cerebrovascular territories after surgery and identified the glucose pathology changes underlying territories.

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Research Applications of Positron Emission Tomography/Magnetic Resonance (PET/MR) Imaging in Cerebrovascular Diseases

Hou,

Zhang,

et al. 2023

PET/MR: Functional and Molecular Imaging of Neurological Diseases and Neurosciences

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Cerebral glucose metabolism changes in chronic ischemia patients following subcranial-intracranial bypass

Cited by 6 publications

References 18 publications

Crossed cerebellar diaschisis-related supratentorial hemodynamic and metabolic status measured by PET/MR in assessing postoperative prognosis in chronic ischemic cerebrovascular disease patients with bypass surgery

Crossed cerebellar diaschisis-related supratentorial hemodynamic and metabolic status measured by PET/MR in assessing postoperative prognosis in chronic ischemic cerebrovascular disease patients with bypass surgery

A Noninvasive Quantification Approach for Monitoring Brain Metabolic Alterations After Surgical Intervention in Ischemic Cerebrovascular Disease

Research Applications of Positron Emission Tomography/Magnetic Resonance (PET/MR) Imaging in Cerebrovascular Diseases

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