ArticleNeurosurgery2026
Toward Semiautomated Analysis of Cerebrovascular Reserve: Enhancing Objective Comparisons Using 99m Tc-HMPAO SPECT With Acetazolamide in Moyamoya.
Article in Neurosurgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesCerebrovascular reserve (CVR) is a key physiological mechanism allowing the brain to adapt to fluctuating perfusion, particularly relevant in the management of neurovascular disorders such as idiopathic (iMM) and syndromic moyamoya (sMM). Although 99m Tc-HMPAO SPECT with acetazolamide is commonly used for CVR assessment, it faces limitations including low spatial resolution, artifacts, and variability in interpretation. This study primarily aims to evaluate a novel, semiautomated, and more objective method for interpreting HMPAO SPECT in CVR assessment. As a secondary objective, the method is applied to a cohort of patients who underwent revascularization surgery for iMM or sMM.
methodsA retrospective analysis was performed on prospectively collected data from a tertiary neuroscience center, including 20 adult patients with iMM (n = 9) or sMM (n = 11). Clinical and imaging data were reviewed. 99m Tc-HMPAO SPECT images were assessed independently by 2 nuclear medicine physicians blinded to clinical details. Images were registered to T1-weighted MRI and overlaid with an arterial territory atlas. Territories classified as healthy by experts were defined as true negatives; all others as altered. Statistical comparisons were made using Student's t-tests with false discovery rate correction.
resultsAmong the 20 patients (12 females), patients with sMM were older and had more cardiovascular risk factors. The proposed method significantly discriminated between altered and healthy perfusion territories. Compared with expert interpretation, the method demonstrated specificities of 93% (iMM) and 92% (sMM), with negative predictive values of 80% and 75%%, respectively.
conclusionAlthough 99m Tc-HMPAO remains a validated modality for CVR assessment, its interpretation is operator-dependent. The proposed semiautomated method offers high specificity and greater objectivity, supporting its integration into clinical workflows. Further multicenter validation is warranted.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.