Abstract
The goal of this study was to develop a simple method for quantification of regional cerebral blood flow (rCBF) with99mTc-ethyl cysteinate dinier (ECD) SPECT. Following an intravenous constant infusion of ECD for one minute, serial dynamic SPECT imaging was performed for 40 minutes in 6 healthy male volunteers with intermittent arterial blood sampling. PET scan with15O-water was performed on the same day before the SPECT study for measurement of rCBF. Arterial blood data demonstrated rapid conversion of ECD to the hydrophilic metabolites, and most of the arterial input to the brain was completed within 5 minutes after the injection. Brain activity reached a peak value soon after the cessation of infusion, and was stable thereafter with very little washout. Net extraction of ECD in the brain calculated by arterial input of ECD and rCBF demonstrated a rapid decrease within a few minutes, reaching 42.7% at 5 minutes. The simulation study suggested that the arterial blood activity obtained by continuous drawing for 5 minutes and a single SPECT scan would provide a reasonable estimate of rCBF under the assumption of constant net extraction in the brain.
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Walovitch RC, Hill TC, Garrity ST, Cheesman EH, Burgess BA, O’Leary DH, et al. Characterization of technetium- 99m-l,l-ECD for brain perfusion imaging, part 1: Pharmacology of technetium-99m ECD in nonhuman primates. JNucl Med 30: 1892–1901, 1989.
Léveillé J, Demonceau G, De Roo M, Rigo P, Taillefer R, Morgan RA, et al. Characterization of technetium-99m-L,L-ECD for brain perfusion imaging, part 2: Biodistribution and brain imaging in humans.J Nucl Med 30: 1902–1910, 1989.
Tsuchida T, Nishizawa S, Yonekura Y, Sadato N, Iwasaki Y, Fujita T, et al. SPECT images of technetium-99m-ethyl cysteinate dimer in cerebrovascular diseases: comparison with other cerebral perfusion tracers and PET.J Nucl Med 35: 27–31, 1994.
Yonekura Y, Tsuchida T, Sadato N, Nishizawa S, Iwasaki Y, Mukai T, et al. Brain perfusion SPECT with99mTc-bicisate: comparison with PET measurement and linearization based on permeability-surface area product model.J Cereb Blood Flow Metab 14: S58-S65, 1994.
Shishido F, Uemura K, Murakami M, Inugami A, Ogawa T, Fujita H, et al. Cerebral uptake of99mTc-bicisate in patients with cerebrovascular disease in comparison with CBF and CMRO2 measured by positron emission tomography.J Cereb Blood Flow Metab 14: S66-S75, 1994.
Tanada S, Murase K, Inoue T, Ochi K, Fujita H, Sakaki S, et al.In vivo comparison of intracerebral behavior of99mTc labeled ECD with99mTc HMPAO using dynamic brain SPECT and a compartment model analysis.J Cereb Blood Flow Metab 11: S769, 1991.
Friberg L, Andersen AR, Lassen NA, Holm S, Dam M. Retention of99mTc-bicisate in the human brain after intracarotid injection.J Cereb Blood Flow Metab 14: S19-S27, 1994.
Sadato N, Yonekura Y, Senda M, Iwasaki Y, Matoba N, Tamaki N, et al. PET and the autoradiographic method with continuous inhalation of oxygen-15-gas: theoretical analysis and comparison with conventional steady-state methods.J Nucl Med 34: 1672–1680, 1993.
Raichle ME, Martin WRW, Herscovitch P, Mintun MA, Markham J. Brain blood flow measured with intravenous H2 15O. II: Implementation and validation.J Nucl Med 24: 790–798, 1983.
Okazawa H, Yonekura Y, Fujibayashi Y, Nishizawa S, Magata Y, Ishizu K, et al. Clinical application and quanti- tative evaluation of generator-produced copper-62-PTSM as a brain perfusion tracer for PET.J Nucl Med 35: 1910–1915, 1994.
Rosenthal MS, Cullom J, Hawkins W, Moore SC, Tsui BMW, Yester M. Quantitative SPECT imaging: a review and recommendations by the focus committee of the Society of Nucler Medicine Computer and Instrumentation Council.J Nucl Med 36: 1489–1513, 1995.
Yonekura Y, Fujita T, Nishizawa S, Iwasaki Y, Mukai T, Konishi J. Temporal changes in accumulation of N-isopropyl-p-iodoamphetamine in human brain: relation to lung clearance.J Nucl Med 30: 1977–1981, 1989.
Yonekura Y, Nishizawa S, Mukai T, Iwasaki Y, Fukuyama H, Ishikawa M, et al. Functional mapping of flow and back-diffusion rate of N-isopropyl-p-iodoamphetamine in human brain.J Nucl Med 34: 839–844, 1993.
Iida H, Itoh H, Nakazawa M, Hatazawa J, Nishimura H, Onishi J, et al. Quantitative mapping of regional cerebral blood flow using iodine-123-IMP and SPECT.J Nucl Med 35: 2019–2030, 1994.
Pupi A, Teresa M, De Christofaro R, Passen A, Castagnoli A, Santoro GM, et al. Quantitation of brain perfusion with99mTc-bicisate and single SPECT scan: comparison with microsphere measurements.J Cereb Blood Flow Metab 14: S28-S35, 1994.
Knudsen GM, Andersen AR, Somnier FE, Videbæk C, Hasselbalch S, Paulson OB. Brain extraction and distribution of99mTc-bicisate in humans and in rats.J Cereb Blood Flow Metab 14: S12-S18, 1994.
Inugami A, Kannno I, Uemura K, Shishido F, Murakami M, Tomura N, et al. Linearization correction of99mTc-labeled hexamethyl-propylene amine oxime (HM-PAO) image in terms of regional CBF distribution: comparison to C15O2 inhalation steady-state method measured by positron emission tomography.J Cereb Blood Flow Metab 8: S52-S60, 1988.
Yonekura Y, Nishizawa S, Mukai T, Fujita T, Fukuyama H, Ishikawa M, et al. SPECT with99mTc-d,l-hexamethylpro-pylene amine oxime (HMPAO) compared with regional cerebral blood flow measured by PET: effects of linearization.J Cereb Blood Flow Metab 8: S82-S89, 1988.
Matsuda H, Tsuji S, Shuke N, Sumiya H, Tonami N, Hisada K. A quantitative approach to technetium-99m hexamethyl-propylene amine oxime.Eur J Nucl Med 19: 195–200, 1992.
Walovitch RC, Francesch M, Picard M, Cheesman EH, Hall KM, Makugh J, et al. Metabolism of99mTc-l,l-ethyl cysteinate dimer in healthy volunteers.Neuropharmacology 30: 283–292, 1991.
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Yonekura, Y., Ishizu, K., Okazawa, H. et al. Simplified quantification of regional cerebral blood flow with99mTc-ECD SPECT and continuous arterial blood sampling. Ann Nucl Med 10, 177–183 (1996). https://doi.org/10.1007/BF03165390
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DOI: https://doi.org/10.1007/BF03165390