Quantitation of rCBF by ^99mTc-Hexamethylpropyleneamine Oxime Single Photon Emission Computed Tomography Combined with ¹³³Xe CBF

Abstract

Summary: A simple, noninvasive method of measuring CBF that uses single photon emission computed tomog raphy (SPECT) of 99mTc-hexamethylpropyleneamine ox ime ( 99 mTc-HMPAO) and whole-brain CBF obtained by 1 33 Xe clearance technique was developed. SPECT data were normalized to the count density of HMP AO uptake in the whole brain and then converted to the absolute units of CBF by multiplying average CBF in the whole brain obtained by 1 33 Xe. Mean CBF values in healthy volunteers (n = 12) were 49 ± 7 and 30 ± 5 ml 100 g-I CBP is useful in assessing brain function in pa tients with cerebral disorders (Kety and Schmidt. , 1948). Of the available CBP single photon tracers, 99mTc-hexamethylpropyleneamine oxime (99mTc_ HMPAO) has the best imaging and dosimetry char acteristics. Many investigators have tried to mea sure the absolute value of regional CBP (rCBP) us ing 99mTc-HMPAO and single photon emission computed tomography (SPECT) (Andersen et aI., 1988; Inugami et aI., 1988; Matsuda et aI. , 1988 Matsuda et aI. , , 1992 Nickel et aI. , 1989; Gemmell et aI. , 1990; Pupi et aI., 1991; Murase et aI. , 1992). However, the kiReceived February 9, 1993; final revision received July 9, 1993; accepted August 2, 1993.Address correspondence and reprint requests to Dr. Y. Isaka at Department of Nuclear Medicine, Osaka National Hospital, Hoenzaka, 2-1-14, Chuo-ku, Osaka, 540, Japan.Abbreviations used: CVD, cerebrovascular disease; HMPAO, hexamethylpropyleneamine oxime; rCBF, regional CBF; ROI, region of interest; SPECT, single photon emission computed to mography; TIA, transient ischemic attack. 353min -I for gray matter and white matter, respectively, with a global flow value of 45 ± 5 mlloo g-I min -I. The mean flow value was 19 ± 7 mlloo g-I min -I for the core of the infarct and 31 ± 5 ml 100 g -1 min -1 for the con tralateral region (n = 13). CBF values were reproducible for all brain regions. The method was convenient to use and suitable for the routine measurement of regional CBF in normal and pathologic states. Key Words: Cerebral blood flow-Hexamethylpropyleneamine oxime-Single photon emission computed tomography-99 mTc_1 33 Xe.netics of 99mTc-HMPAO in the human brain have not been completely determined (Lassen et aI. , 1988; Neirinckx et aI. , 1988), and thus the repro ducibility and clinical relevance of the obtained CBP values have not been studied. Required for use in the routine clinical quantitation of rCBP is a method that permits rapid evaluation at lower cost with higher reproducibility. We describe a noninva sive, simple method for the quantitative assessment of rCBP using 99mTc_HMPAO SPECT combined with the flow value obtained in the whole brain by the 133Xe clearance technique. METHODS CBF SPECT proceduresStudies were conducted in 37 subjects including 12 healthy volunteers (controls) and 25 patients with isch emic cerebrovascular disease (CVD). Five patients had a transient ischemic attack (TIA) and 20 had a completed stroke (lacunar infarction in 7 and cortical infarction in 13). The relationship b...

Cerebral hemodynamics in a healthy population measured by dynamic susceptibility contrast MR imaging

“…Table 2 summarizes the results of previous reports obtained by PET, functional CT, and DSC MRI (10,12,14,22,25,27,33,34,37). The results of the present study agree with those results, albeit the variation of the previously reported values is markedly large.…”

Cerebral Hemodynamics in a Healthy Population Measured by Dynamic Susceptibility Contrast Mr Imaging

“…PET studies have preferred to use absolute estimates of perfusion (9, 14, 34); in DSC MRI, relative measures (27, 37) and only more recently the absolute estimates (12, 22, 33) have been studied. Table 2 summarizes the results of previous reports obtained by PET, functional CT, and DSC MRI (10, 12, 14, 22, 25, 27, 33, 34, 37). The results of the present study agree with those results, albeit the variation of the previously reported values is markedly large.…”

Quantitative characterization of hemodynamic properties and vasculature dysfunction of high‐grade gliomas

“…Scaling factors were chosen for CBVand CBF on the basis of values reported in the literature for white matter (22,23,34). The range of CBV and CBF values for white matter reported in the literature is considerable, depending upon the imaging technology used, the image resolution and the subject/patient conditions (20,(35)(36)(37)(38)(39)(40). As in their previous study, the present authors chose a normal white matter CBV of 1% and a CBF of 30 mL/ 100 g/min (15).…”