Fully automatic input function determination program for simple noninvasive (123)I-IMP microsphere cerebral blood flow quantification method.

We recently developed a simple noninvasive (123)I-IMP microsphere (SIMS) method using chest dynamic planar images and brain single photon emission computed tomography. The SIMS method is an automatic analysis method, except for the process of setting the region of interest (ROI) of the input function. If a fully automatic ROI setting algorithm can be developed to determine the input function for the SIMS method, repeatability and reproducibility of the analysis of regional cerebral blood flow (rCBF) of the SIMS method can be guaranteed. The purpose of this study is to develop a fully automatic input function determination program for the SIMS method and to confirm the clinical usefulness of this program. The automatic input function determination program consists of two ROI setting programs for the PA and lung regions, and it is developed using the image phase analysis of a chest RI angiogram. To confirm the clinical usefulness of this program, the rCBF in 34 patients measured using the automatic method were compared with the values obtained through the manual setting method. Input functions by the automatic and manual methods were approximately equal. A good correlation was observed between the rCBF values obtained by the automatic method and those obtained by the manual setting method (r=0.96, p<0.01). Further, the total time taken for the automatic SIMS analysis is 1-2min as compared to 20-30min for the current analysis, and therefore, this technique contributes to the improvement of the throughput of nuclear medical examinations.