Measurement of regional cerebral blood flow and oxygen utilisation in patients with cerebral tumours using 15O and positron emission tomography: Analytical techniques and preliminary results

Summary

Regional cerebral blood flow and oxygen utilisation have been studied in 8 patients with brain tumours using continuous inhalation of C15O2 and 15O2 and positron emission tomography. The methods used to analyse the regional cerebral pathophysiology are presented. A relative uncoupling between oxygen consumption and blood flow was observed in all tumours as indicated by a decreased regional fractional extraction of oxygen (rOER). This suggests that a major proportion of these tumours had sufficient blood supply to meet oxygen metabolic demand. A decrease of blood flow in grey matter was found both in the affected and contralateral hemispheres of the brain. Matched reductions of flow and oxygen utilisation were observed in oedematous tissue.

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References

  1. 1.

    Jones T, McKenzie CG, Moss S, Buckingham PD, Clark JC (1976) The non-invasive use of oxygen-15 for studying regional brain function in patients with cerebral tumours. In: Egesmann 3 (ed) Radioaktive Isotope in Klinik und Forschung. Gasteiner International Symposium. Vienna, pp 427–434

  2. 2.

    Hoop B jr, Hnatowitch DJ, Brownell GL, Jones T, McKusick KA, Ojemann RG, Parker JA, Subramanyam R, Taveras JM (1976) Techniques for positron scintigraphy of the brain. J Nucl Med 17: 473–479

    PubMed  Google Scholar 

  3. 3.

    McKenzie CG, Jones T, Lenzi GL, Moss S (1977) Oxygen-15 by inhalation in the investigation of cerebral neoplasms. In: Ingvar DH, Lassen NA (eds) Acta Neurol Scand [Suppl] 56: 182–183

  4. 4.

    Lenzi GL, Jones T, McKenzie CG, Buckingham PD, Clark JC, Moss S (1978) Study of regional cerebral metabolism and blood flow relationships in man using the method of continuously inhaling oxygen-15 and oxygen-15 labelled carbon dioxide. J Neurol Neurosurg Psychiatry 41: 1–10

    Google Scholar 

  5. 5.

    McKenzie CG, Lenzi GL, Jones T, Moss S (1978) Radioactive 15O studies in cerebral neoplasms. J R Soc Med 71: 417–425

    Google Scholar 

  6. 6.

    Jones T (1980) Positron emission tomography and measurements of regional tissue function in man. Br Med Bull 36: 231–236

    Google Scholar 

  7. 7.

    Frackowiak RSJ, Lenzi GL, Jones T, Heather JD (1980) Quantitative measurement of regional cerebral blood flow and oxygen metabolism in man using 15O and positron emission tomography: theory, procedure and normal values. J Comput Assist Tomogr 4: 727–736

    Google Scholar 

  8. 8.

    Frackowiak RSJ, Jones T, Lenzi GL, Heather JD (1980) Regional cerebral oxygen utilization and blood flow in normal man using oxygen-15 and positron emission tomography. Acta Neurol Scand 62: 336–344

    PubMed  Google Scholar 

  9. 9.

    Jones T, Rhodes CG, Heather JD, Forse GR, Lammertsma AA, Frackowiak RSJ, Lenzi GL, Selwyn AP, Allan RM, Buckingham PD (1980) The ability to measure quantitatively in three dimensions regional tissue metabolism and blood flow using oxygen-15 and a positron emission tomograph. IAEA International Symposium on Medical Radionuclide imaging. Heidelberg, September 1980, IAEA-SM-247/23 (in press)

  10. 10.

    Lammertsma AA, Ito M, McKenzie CG, Jones T, Frackowiak RSJ (1981) Quantitative tomographic measurements of regional cerebral blood flow and oxygen utilisation in patients with brain tumours using oxygen-15 and positron emission tomography. J Cereb Blood Flow Metab [Suppl] 1: 567–568

    Google Scholar 

  11. 11.

    Jones T, Chesler DA, Ter-Pogossian MM (1976) The continuous inhalation of oxygen-15 for assessing regional extraction in the brain of man. Br J Radiol 49: 339–343

    PubMed  Google Scholar 

  12. 12.

    Subramanyan R, Alpert NM, Hoop B Jr. Brownell GL, Taveras JM (1978) A model for regional cerebral oxygen distribution during continuous inhalation of 15O2 and C15O2. J Nucl Med 19: 48–53

    Google Scholar 

  13. 13.

    Phelps ME, Hoffman EJ, Huang SC, Kuhl DE (1978) ECAT: A new computerized tomographic imaging system for positronemitting radiopharmaceuticals. J Nucl Med 19: 635–647

    PubMed  Google Scholar 

  14. 14.

    Espagno J, Lazorthes Y, (1968) Cerebral blood flow in brain tumours. Scand J Clin Lab Invest [Suppl] 22: 102: 15 (C)

    Google Scholar 

  15. 15.

    Pálpögyi R (1968) Regional cerebral blood flow in tumour patients. Scand J Clin Lab Invest [Suppl] 22: 102: 15 (B)

    Google Scholar 

  16. 16.

    Pálpögyi R (1969) Regional cerebral blood flow in patients with intracranial tumours. J Neurosurg 31: 149–163

    Google Scholar 

  17. 17.

    Wüllenweber R (1968) Intracerebral steal in man recorded by a heat clearance technique. Scand J Clin Lab Invest [Suppl] 22: 102: 15(C)

    Google Scholar 

  18. 18.

    Potchen EJ, Davis DO, Wharton T, Hill R, Taveras JM (1969) A regional cerebral blood flow in man. I: A study of the Xenon-133 washout method. Arch Neurol 20: 378–383

    Google Scholar 

  19. 19.

    Lammertsma AA, Jones T, Frackowiak RSJ, Lenzi GL (1981) A theoretical study of the steady state model for measuring regional cerebral blood flow and oxygen utilization using oxygen-15. J Comput Assist Tomogr 5: 544–550

    PubMed  Google Scholar 

  20. 20.

    Lammertsma AA, Heather JD, Jones T, Frackowiak RSJ, Lenzi GL (1981) A statistical study of the steady state technique for measuring regional cerebral blood flow and oxygen utilization using oxygen-15. J Comput Assist Tomogr (in press)

  21. 21.

    Rhodes CG, Lenzi GL, Frackowiak RSJ, Jones T, Pozzilli C (1981) Measurement of CBF and CMRO2 using the continuous inhalation of C15O2 and 15O2-Experimental validation using CO2 reactivity in the anaethetized dog. J Neurol Sci 50: 381–389

    Article  PubMed  Google Scholar 

  22. 22.

    Davidson JF, Douglas AS (1978) Blood. In: Ledingham IM, MacKay C (eds) Jamieson and Kay's textbook of surgical physiology, 3rd ed. Churchill Livingston, London, pp 135–164

    Google Scholar 

  23. 23.

    Withers HR, Peter LJ (1980) Biological aspects of radiation therapy. In: Fletcher GH (ed) Textbook of radiotherapy, 3rd ed. Lea & Febiger, Philadelphia, pp 103–179

    Google Scholar 

  24. 24.

    Thomlinson RH, Gray LH (1955) The histological structure of some human lung cancers and the possible implications for radiotherapy. Br J Cancer 9: 539–549

    PubMed  Google Scholar 

  25. 25.

    Ter-Pogossian MM, Eichling JO, Davis DO, Welch NA (1970) The measure in vivo of regional oxygen utilization by means of oxyhemoglobin labelled with radioactive oxygen-15. J Clin Invest 49: 381–391

    Google Scholar 

  26. 26.

    Warburg O (1956) On the origin of cancer cells. Science 123: 309–314

    Google Scholar 

  27. 27.

    Irving IH, Elliot KAC (1955) The metabolism of normal brain and human gliomas in relation to cell type and density. Can J Biochem Physiol 33: 395–403

    Google Scholar 

  28. 28.

    Brock M (1971) Cerebral blood flow and intrcranial pressure changes associated with brain hypoxia. In: Brierly JB, Medrum BS (eds) Brain hypoxia. Spartic International Medical Publication, Larenham Press, London, pp 14–19

    Google Scholar 

  29. 29.

    Zülch KJ, Mennel HD, Zimmermann V (1974) Intracranial hypertension. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology, Vol 16. North Holland Publishing, Amsterdam, pp 89–149

    Google Scholar 

  30. 30.

    Langfitt TW, Kassel NF, Weinstein JD (1965) Cerebral blood flow with intracranial hypertension. Neurology 15: 761–773

    Google Scholar 

  31. 31.

    Cronquist S, Lundberg N (1968) Regional cerebral blood flow in intracranial tumours with special regard to cases with intracranial hypertension. Scand J Clin Lab Invest [Suppl] 22: 102: 15(C)

    Google Scholar 

  32. 32.

    Johnson PC (1964) Review of previous studies and current theories of autoregulation. Circ Res [Suppl] 15: 2–9

    Google Scholar 

  33. 33.

    Mossmans PCM (1974) Regional cerebral blood flow in neurological patients. van Gorcum Assen, Netherlands, pp 16–36

    Google Scholar 

  34. 34.

    Lassen NA (1966) The luxury-perfusion syndrome and its possible relation to acute metabolic acidosis localized within the brain. Lancet II: 1113–1115

    Google Scholar 

  35. 35.

    Pappius HM (1974) Fundamental aspects of brain edema. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology, Vol 16. North Holland Publishing. Amsterdam, pp 167–208

    Google Scholar 

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Ito, M., Lammertsma, A.A., Wise, R.J.S. et al. Measurement of regional cerebral blood flow and oxygen utilisation in patients with cerebral tumours using 15O and positron emission tomography: Analytical techniques and preliminary results. Neuroradiology 23, 63–74 (1982). https://doi.org/10.1007/BF00367239

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Key words

  • Cerebral blood flow
  • Cerebral oxygen utilisation
  • Positron emission tomography
  • Cerebral tumours
  • Cerebral oedema