Precise Localization of Dysfunctional Areas in Vertebrobasilar Infarction by FDGand 0-15-H20-PET Using Standardized Image Analysis and Image Registration to 3-D MR

F. D. Juengling; J. Kassubek; E. Moser; E. U. Nitzsche

doi:10.1055/s-0038-1632234

Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 1999; 38(08): 341-344
DOI: 10.1055/s-0038-1632234

Original Article

Schattauer GmbH

Precise Localization of Dysfunctional Areas in Vertebrobasilar Infarction by FDGand 0-15-H20-PET Using Standardized Image Analysis and Image Registration to 3-D MR

Präzise Läsions-Lokalisation mittels FDGund 0-15-H20-PET durch standardisierte Bildanalyse-Algorithmen und Bildregistrierung mit 3D-MR am Beispiel eines Mittelhirninfarktes

F. D. Juengling

¹Division of Nuclear Medicine, Department of Radiology, Department of Neurology, University Hospital Freiburg, Germany

,

J. Kassubek

¹Division of Nuclear Medicine, Department of Radiology, Department of Neurology, University Hospital Freiburg, Germany

,

E. Moser

¹Division of Nuclear Medicine, Department of Radiology, Department of Neurology, University Hospital Freiburg, Germany

,

E. U. Nitzsche

¹Division of Nuclear Medicine, Department of Radiology, Department of Neurology, University Hospital Freiburg, Germany

› Author Affiliations

Abstract

Summary

The advantages of standardized multimodal image analysis are demonstrated in a case of symptomatic tremor after basilar thrombosis. Functionally and structurally lesioned areas were mapped in Talairach space using 3-D MRI, cerebral FDG-PET and 0-15-H₂0-PET. Structural lesions were found in the left midbrain, thalamus, putamen and cerebellar areas. Voxel-based statistics in comparison to a normal data base revealed hypometabolism in the left thalamus, left red nucleus, left cerebellar hemisphere including dentate nucleus and in the left inferior olivary nucleus. The 0-15-H₂0-PET investigation revealed metabolic uncoupling along the rubroolivocerebellar loop. Given the delicate anatomy of the structures involved, image registration and standardized image analysis techniques are essential for a synoptic multimodality analysis of morphological and functional pathology and should generally be used for cerebral PET investigations.

Zusammenfassung

Die Vorteile der standardisierten multimodalen Bildverarbeitung werden anhand eines Falles von symptomatischem Tremor in Folge einer Basilaristhrombose beschrieben. Funktionell und strukturell geschädigte Hirnareale wurden im stereotaktischen Talairach-Raum mittels dreidimensionalem MRI, zerebralem FDG-PET und 0-15-H₂0-PET dargestellt. Strukturelle Läsionen fanden sich im linken Mittelhirn, Thalamus, Putamen und zerebellär. Eine voxelbasierte statistische Auswertung im Vergleich zu einer Normaldatenbank zeigte hypometabole Areale im linken Thalamus, linken Nucleus ruber und links zerebellär sowie im linken Nucleus olivarius inferior. Die 0-15-H₂0-PET-Untersuchung wies eine metabolische Entkopplung entlang der rubroolivocerebellären Schleife nach. In Anbetracht der komplexen Anatomie der beteiligten Strukturen erscheinen Bildregistrierung und standardisierte Bildanalyse als unabdingbar für eine multimodale Analyse zerebraler morphologischer und funktioneller Pathologie und sollten die Grundlage jeder zerebralen PET-Untersuchung darstellen.

Key words

MRI - FDG-PET - 0-15-H20-PET - image registration

Schlüsselwörter

MRI - FDG-PET - 0-15-H20-PET - Bildregistrierung

Full Text

References

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