Clinical Blood Flow Measurement with [15O] Water and Positron Emission Tomography (PET)

  • Richard D. Hichwa
  • Laura L. Boles Ponto
  • G. Leonard Watkins


[15O]-labeled water has been used to measure brain blood flow for many years (Herscovitch, et al. 1983). While now considered a common procedure, it remains difficult to consistently perform quantitative PET blood flow measurements at most institutions. Blood flow as measured with [15O] H2O remains the only technique, in the majority of clinical PET centers, that can be performed very quickly and repeatedly to assess the cognitive state of a patient or research subject. The most widely used PET radiopharmaceutical, 2-[18F]fluoro-2-deoxy-D-glucose ([18F] FDG) clearly shows metabolic function of brain, heart or tumor. However, its long half-life (110 min) precludes performing repeat studies on the same day. Only one temporal assessment of function with [18F] FDG can be obtained when the patient is at the PET Center. The short half-life of [15O] (122 sec) permits multiple assessments to occur especially if intervention is planned (drug or cognitive activation). [15O] water can easily be produced on demand within a short time without significant radiochemistry involvement. Blood flow to other organs and tissues (bone marrow, heart or tumor) is also possible and is routinely performed at this institution.


Positron Emission Tomography Cerebral Blood Flow Arterial Input Function Blood Flow Measurement Dose Calibrator 
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  1. Bol, A.., Vanmelckenbeke, P., Michel, C., Cogneau, M., Goflïnet, A.M., 1990, Measurement of cerebral blood flow with a bolus of oxygen-15-labelled water: Comparison of dynamic and integral methods, Eur J. Nuc Med. 17: 234–241.CrossRefGoogle Scholar
  2. Callahan, F.J., 1985, “Swagelok® Tube Fitting and Installation Manual”, Crawford Fitting Company, Niagara Falls, Ontario.Google Scholar
  3. Clark, J.C., Buckingham, P.D., 1975, “Short-lived Radioactive Gases for Clinical Use,” Butterworths, London.Google Scholar
  4. Cyclone 3, 18/9, 30, IBA (Ion Beam Applications), Chemin du Cyclotron 2, B-1348 Louvain-La-Neuve, Belgium.Google Scholar
  5. Ginsberg, M.D., Lockwood, A.H., Busto, R., Finn, R.D., Butler, C.M., Cendan, I.E., Goddard, J., 1982, A simplified in vivo autoradiographic strategy for the determination of regional cerebral blood flow by positron emission tomography: Theoretical considerations and validation studies in the rat. J. Cerebral Blood Flow Metab. 2: 89–98.CrossRefGoogle Scholar
  6. Helus, F., Colombetti, L.G., 1983, “Radionuclides Production: Volume I”, CRC Press, Inc., Boca Raton, Florida.Google Scholar
  7. Herscovitch, P., Markham, J., Raichle, M.E., 1983, Brain blood flow measured with intravenous H2–150. I. Theory and error analysis, J. Nuc Med. 24: 782–789.Google Scholar
  8. Herscovich, P., Raichle, M.E., Kilbourn, M.R., Welch, M.J., 1987, Positron emission tomographic measurement of cerebral blood flow and permeability-surface area product of water using [15O]water and [nC]butanol, J. Cerebral Blood Flow Metab. 7: 527–542.CrossRefGoogle Scholar
  9. Hichwa, R.D., Nickles, R.J., 1979, The tuned pipeline — A link between small accelerators and nuclear medical needs, IEEE Trans Nucl Sci. NS-26: 1701–1709.CrossRefGoogle Scholar
  10. Hichwa, R.D., Johnston, D.J., Ponto, L.L., Watkins, G.L., 1991, Handheld automated injector for 0–15 water studies, J. Nucl Med. 32: 1063Google Scholar
  11. Howard, B.E., Ginsberg, M.D., Hassel, W.R., Lockwood, A.H., Freed, P., 1983, On the uniqueness of cerebral blood flow measured by the in vivo autoradiographic strategy and positron emission tomography, J. Cerebral Blood Flow Metab. 3: 432–441.CrossRefGoogle Scholar
  12. Hurtig, R.R., Hichwa, R.D., O’Leary, D.S., Ponto, L.L.B., Narayana, S., Watkins, G.L., Andreasen, N.C., 1994, A quantitative assessment of the timing and duration of cognitive activation in [15O] water PET studies, J. Cerebral Blood Flow Metab. in press.Google Scholar
  13. Iida, H., Kanno, I., Miura, S., Murakami, M., Takahashi, K., Uemura, K., 1986, Error analysis of a quantitative cerebral blood flow measurement using H2 15O autoradiography and positron emission tomography, with respect to the dispersion of the input function, J. Cerebral Blood Flow Metab. 6: 536–545.CrossRefGoogle Scholar
  14. Iida, H., Higano, S., Tomura, N., Shishido, F., Kanno, I., Miura, S., Murakami, M., Takahashi, K., Sasaki, H., Uemura, K., 1988, Evaluation of regional differences of tracer appearance time in cerebral tissues using [15O]water and dynamic positron emission tomography, J. Cerebral Blood Flow Metab. 8: 285–288.CrossRefGoogle Scholar
  15. Iida, H., Kanno, I., Miura, S., Murakami, M., Takahashi, K., Uemura, K., 1989, A deterrnination of the regional brain/blood partition coefficient of water using dynamic positron emission tomography, J. Cerebral Blood Flow Metab. 9: 874–885.CrossRefGoogle Scholar
  16. Kanno, I., Iida, H., Miura, S., Murakami, M., Takahashi, K., Sasaki, H., Inugami, A., Shishido, F., Uemura, K., 1987, A system for cerebral blood flow measurement using an H2 15O autoradiographic method and positron emission tomography, J. Cerebral Blood Flow Metab. 7: 143–153.CrossRefGoogle Scholar
  17. Kanno, I., Iida, H., Miura, S., Murakami, M., 1991, Optimal scan time of oxygen-15-labeled water injection method for measurement of cerebral blood flow, J. Nuc Med. 32: 1931–1934.Google Scholar
  18. Kety, S., 1951, The theory and application of the exchange of inert gas at the lungs and tissue., Pharmacological Reviews 3: 1–41.PubMedGoogle Scholar
  19. Koeppe, R.A., Holden, J.E., Polcyn, R.E., et al., 1985, Quantitation of local cerebral blood flow and partition coefficient without arterial sampling: Theory and validation, J. Cerebral Blood Flow Metab. 5: 214–224.CrossRefGoogle Scholar
  20. Koeppe, R.A., Hutchins, G.D., Rothley, J.M., Hichwa, R.D., 1987, Examination of assumptions for local cerebral blood flow studies in PET, J. Nucl Med. 28: 1695–1703.PubMedGoogle Scholar
  21. Larson, K.B., Markham, J., Raichle, M.E., 1987, Tracer-kinetic models for measuring cerebral blood flow using externally detected radiotracers, J. Cerebral Blood Flow Metab. 7: 443–463.CrossRefGoogle Scholar
  22. Madsen, M.T., Ponto, J.A., 1992, “Medical Physics Handbook of Nuclear Medicine”, Medical Physics Publishing, Madison, Wisconsin.Google Scholar
  23. Meyer, E., 1989, Simultaneous correction for tracer arrival delay and dispersion in CBF measurements by the H2 15O autoradiographic method and dynamic PET, J. Nuc Med. 30: 1069–1078.Google Scholar
  24. NHVG, PracSys Corp., 400 West Cummings Park, Suite 6650, Woburn, MA 01801.Google Scholar
  25. PETtrace, GEMS (G E Medical Systems), P.O. Box 414, Milwaukee, WI 53201.Google Scholar
  26. Raichle, M.E., Martin, W.R.W., Herscovitch, P., Mintun, M.A., Markham, J., 1983, Brain blood flow measured with intravenous H2–150. II. Implementation and validation, J. Nuc Med. 24: 790–798.Google Scholar
  27. RDS, Siemens Medical Systems, 2501 Barrington Road, Hoffman Estates, IL 60195.Google Scholar
  28. TR 30/15, Ebco Tech, 7851 Alderbridge Way, Richmond, B.C. V6X 2A4 Canada.Google Scholar
  29. Volkow, N.D., Mullani, N., Gould, L.K., Adler, S.S., Gatley, S.J., 1991, Sensitivity of measurements of regional brain activation with oxygen-15-water and PET to time of stimulation and period of image reconstruction, J. Nuc Med. 32: 58–61.Google Scholar

Copyright information

© Springer Science+Business Media New York 1995

Authors and Affiliations

  • Richard D. Hichwa
    • 1
  • Laura L. Boles Ponto
    • 1
  • G. Leonard Watkins
    • 1
  1. 1.P.E.T. Imaging Center, Department of RadiologyUniversity of Iowa Medical SchoolIowa CityUSA

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