V. Bettinardi

Localization of grasp representations in humans by PET: 1. Observation versus execution

Positron emission tomography (PET) was used to localize brain regions that are active during the observation of grasping movements. Normal, right-handed subjects were tested under three conditions. In the first, they observed grasping movements of common objects performed by the experimenter. In the second, they reached and grasped the same objects. These two conditions were compared with a third condition consisting of object observation. On the basis of monkey data, it was hypothesized that during grasping observation, activations should be present in the region of the superior temporal sulcus (STS) and in inferior area 6. The findings in humans demonstrated that grasp observation significantly activates the cortex of the middle temporal gyrus including that of the adjacent superior temporal sulcus (Brodmanns area 21) and the caudal part of the left inferior frontal gyrus (Brodmanns area 45). The possible functional homologies between these areas and the monkey STS region and frontal area F5 are discussed.

Rapid Assessment of Regional Cerebral Metabolic Abnormalities in Single Subjects with Quantitative and Nonquantitative [18F]FDG PET: A Clinical Validation of Statistical Parametric Mapping

The [18F]fluorodeoxyglucose ([18F]FDG) method for measuring brain metabolism has not the wide clinical application that one might expect, partly because of its high cost and the complexity of the quantification procedure, but also because of reporting techniques based on region of interest (ROI) analysis, which are time-consuming and not fully objective. In this paper we report a clinical validation of statistical parametric mapping (SPM) using rCMRglc (quantitative) and radioactivity distribution (nonquantitative) [18F]FDG PET data. We show that a 10-min noninteractive voxel-based SPM analysis on a standard workstation enables objective assessment, including localization in stereotactic space, of regional glucose consumption abnormalities, whose reliability can be assessed on statistical and clinical grounds. Clinical validity was established using a small series of patients with degenerative or developmental disorders, including probable Alzheimers disease, progressive aphasia, multiple sclerosis, developmental specific language impairment, and epilepsy. Analysis of quantitative and nonquantitative data showed the same pattern of results, suggesting that, for clinical purposes, quantitation and invasive arterial cannulation can be avoided. This should facilitate a wider application of the technique and the extension of SPM clinical analysis to H215O PET or high resolution SPECT perfusion studies.

Neural control of fast-regular saccades and antisaccades: an investigation using positron emission tomography

Abstractu2002Regional cerebral blood flow changes related to the performance of two oculomotor tasks and a central fixation task were compared in ten healthy human subjects. The tasks were: (a) performance of fast-regular saccades; (b) performance of voluntary antisaccades away from a peripheral cue; (c) passive maintenance of central visual fixation in the presence of irrelevant peripheral stimulation. The saccadic task was associated with a relative increase in activity in a number of occipitotemporal areas. Compared with both the fixation and the saccadic task, the performance of antisaccades activated a set of areas including: the superior and inferior parietal lobules, the precentral and prefrontal cortex, the cingulate cortex, and the supplementary motor area.The results of the present study suggest that: (a) compared with self-determined saccadic responses the performance of fast regular, reflexive saccades produces a limited activation of the frontal eye fields; (b) in the antisaccadic task the inferior parietal lobes subserve operations of sensory-motor integration dealing with attentional disengagement from the initial peripheral cue (appearing at an invalid spatial location) and with the recomputation of the antisaccadic vector on the basis of the wrong (e.g., spatially opposite) information provided by the same cue.

Metabolic Impairment in Human Amnesia: A PET Study of Memory Networks

Human amnesia is a clinical syndrome exhibiting the failure to recall past events and to learn new information. Its “pure” form, characterized by a selective impairment of long-term memory without any disorder of general intelligence or other cognitive functions, has been associated with lesions localized within Papezs circuit and some connected areas. Thus, amnesia could be due to a functional disconnection between components of this or other neural structures involved in long-term learning and retention. To test this hypothesis, we measured regional cerebral metabolism with 2-[18F]fluoro-2-deoxy-d-glucose ([18F]FDG) and positron emission tomography (PET) in 11 patients with “pure” amnesia. A significant bilateral reduction in metabolism in a number of interconnected cerebral regions (hippocampal formation, thalamus, cingulate gyrus, and frontal basal cortex) was found in the amnesic patients in comparison with normal controls. The metabolic impairment did not correspond to alterations in structural anatomy as assessed by magnetic resonance imaging (MRI). These results are the first in vivo evidence for the role of a functional network as a basis of human memory.

Hemispheric asymmetries and bimanual asynchrony in left- and right-handers

Abstractu2002It is known that, when both forearms are rotated rhythmically and symmetrically, the dominant hand leads in time by about 25 ms, irrespective of movement speed. Positron emission tomography was used to test the hypothesis that the asynchrony results from a functional hemispheric asymmetry. We found that in normal, adult right-handers portions of the motor and premotor motor areas are more active in the left than in the right hemisphere. The converse pattern was observed in left-handers. The results suggest that at least some components of the neural processing involved in bimanual coordination are carried out only in the hemisphere contralateral to the dominant hand. In particular, between-hands asynchrony may reflect the time for dispatching pace-setting commands to the contralateral hemisphere.

An automatic classification technique for attenuation correction in positron emission tomography.

Abstract. In this paper a clustering technique is proposed for attenuation correction (AC) in positron emission tomography (PET). The method is unsupervised and adaptive with respect to counting statistics in the transmission (TR) images. The technique allows the classification of pre- or post-injection TR images into main tissue components in terms of attenuation coefficients. The classified TR images are then forward projected to generate new TR sinograms to be used for AC in the reconstruction of the corresponding emission (EM) data. The technique has been tested on phantoms and clinical data of brain, heart and whole-body PET studies. The method allows: (a) reduction of noise propagation from TR into EM images, (b) reduction of TR scanning to a few minutes (3xa0min) with maintenance of the quantitative accuracy (within 6%) of longer acquisition scans (15–20xa0min), (c) reduction of the radiation dose to the patient, (d) performance of quantitative whole-body studies.

Correlation of SPECT and PET cardiac images by a surface matching registration technique

Complementary information provided by Single Photon and Positron Emission Tomography (SPECT and PET) in nuclear cardiology allows a better comprehension of the physiopathology of the heart. In this work a surface matching registration technique is evaluated in the spatial correlation of SPECT and PET cardiac images. The method is based on matching correspondent anatomical surfaces extracted from transmission (TR) SPECT and PET studies, usually performed for attenuation correction. The accuracy of the technique was evaluated by phantom experiments and on patient data (201Tl SPECT and 13NH3 PET perfusion studies). An application of the method is presented for the correlation of SPECT 201Tl perfusion and PET 18FDG metabolic studies in the evaluation of myocardial viability.

Matching a computerized brain atlas to multimodal medical images

A method for matching a digital brain anatomical atlas to multimodal medical images (MRI, PET, and SPET) was implemented. The digital atlas was derived from anatomical templates of the brain, cut according to the orbitomeatal orientation. The atlas consists of a set of contiguous slices schematically describing the brain as anatomical contours and of a set of regions of interest (ROIs) classifying the brain into functionally homogeneous areas. The matching procedure includes (a) an edge detection method for the extraction of anatomical contours and (b) a warping algorithm based on contour matching to fit the atlas to the individual brain anatomy, as described by MRI. Once the atlas is matched to MRI, the associated templates of ROI can be overlapped with functional PET/SPET studies, individually registered to MRI. The method was tested on MRI studies. The efficacy of the warping algorithm in overlapping atlas and MRI contours was assessed by calculating for each slice an index representing the extent of overlapping (I). Values of I in the range 0.8-0.9 were found (I = 1 complete overlapping). Local accuracy was also verified by comparing the position of correspondent anatomical ROI in the atlas and MRI images before and after warping. The atlas-matching procedure was applied to representative MRI/PET clinical images for an objective regional analysis of functional data.

Lesion detectability and quantification in PET/CT oncological studies by Monte Carlo simulations

The aim of this work was to assess lesion detectability and quantification in whole body oncological /sup 18/F-FDG studies performed by a state-of-the-art integrated Positron Emission Tomograph/computed tomography (PET/CT) system. Lesion detectability and quantification were assessed by a Monte Carlo (MC) simulation approach as a function of different physical factors (e.g., attenuation and scatter), image counting statistics, lesion size and position, lesion-to-background radioactivity concentration ratio (L/B), and reconstruction algorithms. The results of this work brought to a number of conclusions. The MC code PET-electron gamma shower (EGS) was accurate in simulating the physical response of the considered PET/CT scanner (>90%). PET-EGS and patient-derived phantoms can be used in simulating/sup 18/ F-FDG PET oncological studies. Counting statistics is a dominant factor in lesion detectability. Correction for scatter (from both inside and outside the field of view) is needed to improve lesion detectability. Iterative reconstruction and attenuation correction must be used to interpret clinical images. Re-binning algorithms are appropriate for whole-body oncological data. A MC-based method for correction of partial volume effect is feasible. For the considered PET/CT system, limits in lesion detectability were determined in situations comparable to those of real oncological studies: at a L/B=3 for lesions of 12 mm diameter and at a L/B=4 for lesions of 8 mm diameter.

A hybrid method of attenuation correction for positron emission tomography brain studies

A hybrid method for attenuation correction (HAC) in positron emission tomography (PET) brain studies is proposed. The technique requires the acquisition of two short (1 min) transmission scans immediately before or after the emission study, with the patient and the head fixation system in place and after removing the patient from the scanner with the head fixation system alone. The method combines a uniform map of attenuation coefficients for the patients head with measured attenuation coefficients for the head fixation system to generate a hybrid attenuation map. The HAC method was calibrated on 30 PET cerebral studies for comparison with the conventional measured attenuation correction method by ROI analysis. Average differences of less than 3% were found for cortical and subcortical regions. The HAC technique is particularly suitable in a PET clinical environment, allowing a reduction of the total study time, greater comfort for patients and an increase in patient throughput.