Itoh H, Iida H, Murakami M, Bloomfield P M, Miura S, Okudera T, Inugami A, Ogawa T, Hatazawa J, Fujita H
Department of Radiology and Nuclear Medicine, Research Institute for Brain and Blood Vessels-Akita, Japan.
Kaku Igaku. 1993 Jan;30(1):13-23.
IMP is a flow tracer due to a large first pass extraction fraction and high affinity in the brain, but significant clearance from the brain causes change of distribution when the scan start time is delayed. The purpose of the present study is to develop a new method to rapidly calculate a quantitative CBF image by taking into account for the clearance effects. A dynamic SPECT scan was performed on 5 subjects (4 patients with cerebral infarction and 1 normal volunteer) following slow intravenous infusion of 123I-IMP. The arterial input function was obtained by frequent blood sampling and by measuring an octanol extraction ratio for each sample. Firstly, non-linear least square fitting (NLS) was performed to investigate the tracer kinetics of 123I-IMP. The 3 compartment model analysis yielded negligibly small k3 (retaining rate constant) (0.0056 +/- 0.0128 (ml/ml/min)), and consistent k1 (transport rate constant) with those determined by 2 compartment model (2CM) analysis (r = 0.96, p < 0.001). In addition, k1 was consistent with CBF measured by 15O water PET technique. These observations suggested validity of using 2CM for describing the IMP tracer kinetics. Secondly, a weighted integration (WI) technique has been implemented to calculate rapidly images of CBF and partition coefficient (Vd). The WI technique yielded values of CBF (k1) and Vd (k1/k2). They were confirmed to be consistent with those determined by NLS technique (CBF; r = 0.99, p < 0.001, Vd; r = 0.99, p < 0.001), and calculated k1 agreed well with PET CBF (r = 0.91, p < 0.001). We observed changed Vd in infarcted patients. This supports an importance for calculating of Vd image. Vd image will provide additional clinical information because 123I-IMP binding mechanism may be related to cell viability.
由于首过提取率高且在脑内亲和力强,IMP是一种血流示踪剂,但扫描开始时间延迟时,脑内显著的清除作用会导致分布变化。本研究的目的是开发一种新方法,通过考虑清除效应来快速计算定量脑血流量(CBF)图像。在缓慢静脉注射123I-IMP后,对5名受试者(4例脑梗死患者和1名正常志愿者)进行了动态单光子发射计算机断层扫描(SPECT)。通过频繁采血并测量每个样本的辛醇提取率来获得动脉输入函数。首先,进行非线性最小二乘法拟合(NLS)以研究123I-IMP的示踪剂动力学。三室模型分析得出的k3(保留速率常数)极小(0.0056±0.0128(ml/ml/分钟)),且k1(转运速率常数)与两室模型(2CM)分析确定的值一致(r = 0.96,p < 0.001)。此外,k1与通过15O水正电子发射断层扫描(PET)技术测量的CBF一致。这些观察结果表明使用2CM描述IMP示踪剂动力学的有效性。其次,已实施加权积分(WI)技术以快速计算CBF和分配系数(Vd)图像。WI技术得出了CBF(k1)和Vd(k1/k2)的值。证实它们与通过NLS技术确定的值一致(CBF;r = 0.99,p < 0.001,Vd;r = 0.99,p < 0.001),并且计算得出的k1与PET CBF吻合良好(r = 0.91,p < 0.001)。我们观察到梗死患者的Vd发生了变化。这支持了计算Vd图像的重要性。Vd图像将提供额外的临床信息,因为123I-IMP的结合机制可能与细胞活力有关。