Between 0.2-1% of the population is epileptic. Approximately one quarter
of epileptics are refractory to medical treatment and most have temporal
lobe epilepsy. These patients are candidates for temporal lobectomy.
Unfortunately, after surgery, many suffer a loss in naming ability. This
is one example where if the sensitivity of a PET activation study were
improved so that significant results for a single individual could be
attained, management of the patient might be improved. The purpose of this
project is to enhance PET activation imaging until this is possible. To
date, PET activation studies have been used to form conclusions concerning
groups of patients. This work intends to enhance activation studies so
that significant conclusions can be drawn on individual patients.
This work is an investigation into five areas of the PET activation
technique. First, side-by-side tests comparing (15-0)water and (15-
0)butanol will be performed. (15-O)Butanol has been proposed (but not
validated) as a potentially superior radiotracer because it is more freely
diffusible across the blood brain barrier. The second area is an
optimization of the acquisition protocol to maximize the information in a
PET study. In this subproject, the relative timing between the task onset
and the data acquisition, the duration of the acquisition, and the task
presentation will be investigated. Included is an investigation into the
effects of habituation. The confrontational naming stimulus task will be
used but our intention is to produce a set of general principles for
optimizing any activation task. Third, an objective method for identifying
activated regions of the brain will be developed. The innovation in the
proposed work is to directly manipulate the primary data (2D or 3D
sinograms), where the statistical properties are known, to produce images
with equal variance in every pixel (Z-images). From the Z-images, the
probability that any particular region of the brain has been activated can
be obtained. Given an acceptable false positive rate, all significantly
activated regions are determined objectively. Fourth, recent PET scanner
developments have provided the ability to collect 3D data. With 3D data
acquisition, the interplane septa are removed to increase (by an order of
magnitude) the overall sensitivity of the scanner but the increase is not
uniform across the imaging field of view. Also, the image contrast is
reduced because of a greatly increased scatter fraction. The Z-image
methods will be used in side-by-side tests of 2D versus 3D PET data
acquisition to determine the relative advantages of each.
We anticipate that the cumulative improvement from each of these
subprojects will produce a PET activation technique that is able to provide
significant conclusions concerning individual patients. This work is a
proof of principle project. The techniques developed here, specifically for
studying epilepsy, are equally applicable to transferring other PET
activation research to the clinical setting. Our long term goals are to
develop a range of diagnostic activation tests that will allow a physician
to treat neuro illnesses based on the neurobiology of their disease rather
than relying solely on the presenting symptoms.
No Sub Projects information available for 5R29MH053467-03
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