Abstract
SPECT images of the brain can be obtained using either 123I labelled amines or 99mTc-hexamethylpropyleneamineoxime (HM-PAO). Both materials produce images which are blood flow dominated and so appear similar in normal subjects, although the respective mechanisms of uptake are not yet finally established. It seems likely, however, that the different mechanisms of uptake are responsible for recent reports of some differences seen in images obtained with the two types of agent in patients with cerebral pathology, mainly cerebrovascular disease. In this study, 12 demented patients, 6 with dementia of the Alzheimer type (DAT) and 6 with multi infarct dementia (MID), were imaged with 123I-isopropylamphetamine (IMP) and 99mTc-HM-PAO and the images compared. Significantly more lesions were seen with IMP than HM-PAO (P<0.02); out of a possible 120 sites, 41 lesions were seen with IMP compared to 28 with HM-PAO, 23 being seen with both agents. However, it is concluded that either agent can be used for the differential diagnosis of dementia, a task for which the new cerebral blood flow agents seem well suited.
Similar content being viewed by others
References
Armitage P (1971) Statistical methods in medical research Oxford, Blackwell Scientific Publications
Biersack HJ, Hartmann A, Reichmann K, Broich K, Tsuda Y, Winkler C (1987) Comparative brain imaging (SPECT) with 99m Tc-HMPAO and 123-I labelled amphetamine derivatives. J Nucl Med 28:569
Buell U, Krappel W, Schmiedek P, Einhaupl K (1986) Regional iodoamphetamine (I-123 IMP) uptake (SPECT) and regional cerebral blood flow (Xe-133 (SPECT)). In: Biersack HJ, Winkler C (eds) Amphetamines and pH-shift agents for brain imaging. Walter de Gruyter, Berlin, p 127–137
Chesser R, Gemmell HG (1982) The interfacing of a gamma camera to a DEC Gamma-11 data processing system for single photon emission tomography. Phys Med Biol 27:437–441
Cohen MB, Graham LS, Lake R, Metter EJ, Fitten J, Kulkarni MK, Sevrin R, Yamada L, Chang CC, Woodruff N, Kling A (1986) Diagnosis of Alzheimer's disease and multiple infarct dementia by tomographic imaging of I-123 IMP. J Nucl Med 27:769–774
Creutzig H, Schober O, Gielow P, Friedrich R, Becker H, Dietz H, Hundeshagen H (1986) Cerebral dynamics of N-Isopropyl-(I-123)p-Iodoamphetamine. J Nucl Med 17:178–183
Defer G, Moretti J-P, Cesaro P, Sergent A, Raynaud C, Degos J-P (1987) Early and delayed SPECT using N-Isopropyl-p-iodoamphetamine I-123 in cerebral ischaemia. A prognostic index for clinical recovery. Arch Neurol 44:715–718
Deisenhammer E, Hoell K, Luft Ch, Steinhaeusel H, Brugger A (1987) Analysis of distribution of I-123 IMP and Tc-99m HMPAO with early and late SPECT in cerebrovascular disease. J Nucl Med 28:591
Ell PJ, Cullum I, Donaghy M, Lui D, Jarritt PH, Harrison MJG (1983) Cerebral blood flow studies with I-123 labelled amines. Lancet i:1348–1352
Ell PJ, Hocknell JML, Jarritt PH, Cullum I, Lui D, Campos-Costa D, Nowotnik KP, Pickett RD, Canning LR, Neirinckx RD (1985) A Tc-99m labelled radiotracer for the investigation of cerebral vascular disease. Nucl Med Commun 6:637–441
Gemmell HG, Sharp PF, Evans NTS, Besson JAO, Lyall D, Smith FW (1984) Single photon emission tomography with I-123 Isopropylamphetamine in Alzheimer's disease and multi-infarct dementia. Lancet ii:1348
Gemmell HG, Sharp PF, Besson JAO, Crawford JR, Ebmeier KP, Davidson J, Smith FW (1987) Differential diagnosis in dementia using the cerebral blood flow agent Tc-99m HM-PAO: A SPECT study. J Comput Assist Tomogr 11:398–402
Hachinski VC, Illiff LD, Dilhka E (1975) Cerebral blood flow in dementia. Arch Neurol 32:632–637
Konig B, Kohn H, Mostbeck A (1987) Qualitative and semiquantitative comparison of 99m-Tc-HM-PAO and 123-I IMP for regional blood flow imaging. Nucl Med 26:94
Kuhl DE, Barrio JR, Huang S-C, Selin C, Ackerman RF, Lear JL, Wu JL, Phelps ME (1982) Quantifying local cerebral blood flow by n-isopropyl-p-I-123-iodoamphetamine (IMP) tomography. J Nucl Med 23:196–203
Lassen NA, Henrickson L, Holm S, Barry DI, Paulson DB, Vorstrup S, Rapin J, Le Poncin-Lafitte M, Moretti JL, Askienazy S, Raynaud C (1983) Cerebral blood flow tomography: Xenon-133 compared with isopropyl-amphetamine-iodine-123: Concise communication. J Nucl Med 24:17–21
Leonard J-P, Nowotnik DP, Neirinckx RD (1986) Tc-99m-d, 1-HM-PAO: a new radiopharmaceutical for imaging regional brain perfusion using SPECT — a comparison with I-123 HIPDM. J Nucl Med 27:1819–1823
Neirinckx RD, Canning LR, Piper IM, Nowotnik DP, Pickett RD, Holmes RA, Volkert WA, Forster AM, Weisner PS, Marriott JA, Chaplin SB (1987a) Tc-99m d,l-HM-PAO: a new radiopharmaceutical for SPECT imaging of regional cerebral blood perfusion. J Nucl Med 28:191–202
Neirinckx RD, Harrison RC, Forster AM, Burke JF, Anderson AR, Lassen NA (1987b) A model for the in-vivo behaviour of Tc-99m d,l HM-PAO in man. J Nucl Med 28:559
Nishizawa S, Yonekura, Fujita T, Senda M, Mukai T, Saji H, Shibata T, Yamoto K, Tamaki N, Fukuyama H, Harada K, Ishikawa, Torizuka K (1987) Brain perfusion SPECT with Tc-99m HM-PAO: comparative study with I-123 and CBF measured by PET. J Nucl Med 28:569
Royal HD, Hill TC, Holman BL (1985) Clinical brain imaging with isopropyl-iodoamphetamine and SPECT. Seminars in Nuclear Medicine 15:357–376
Sakai F, Ishii K, Aoki S, Igarashi H, Nakazawa K, Tazaki Y (1987) Critical appraisal of I-123 tracer kinetics for the measurement of cerebral blood flow in man. J Nucl Med 28:569
Sharp PF, Smith FW, Gemmell HG, Lyall D, Evans NTS, Gvozdanovich D, Davidson J, Tyrell DA, Pickett RD, Neirinckx RD (1986a) Technetium-HM-PAO stereoisomers as potential agents for imaging regional cerebral blood flow: human volunteer studies. J Nucl Med 27:171–177
Sharp PF, Gemmell HG, Cherryman G, Besson JAO, Crawford J, Smith FW (1986b) The application of 123-I labelled isopropyl-amphetamine to the study of dementia. J Nucl Med 27:761–768
Spreafico G, Gamelli F, Gadola G, Nicola G, Zancancer F, Tonarelli G, Sala E, Freschi R (1987) Initial experience with SPECT of the brain using Tc-99m-hexamethyl-propyleneamne oxime (Tc-99m-HM-PAO). Eur J Nucl Med 12:557–559
Spitzer RL, Endicott J, Robins E (1978) Research diagnostic criteria: rationale and reliability. Arch Gen Psych 35:773–782
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Gemmell, H.G., Sharp, P.F., Besson, J.A.O. et al. A comparison of Tc-99m HM-PAO and I-123 IMP cerebral SPECT images in Alzheimer's disease and multi-infarct dementia. Eur J Nucl Med 14, 463–466 (1988). https://doi.org/10.1007/BF00252389
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00252389