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Measurement of Regional Cerebral Glucose Utilization with Fluorine-18-FDG and PET in Heterogeneous Tissues: Theoretical Considerations and Practical Procedure

INB-CNR, Department of Nuclear Medicine University of Milan, Institute H. San Raffaele, Milan, Italy
Laboratory of Cerebral Metabolism, National Institute of Mental Health, Bethesda, Maryland

Correspondence: For correspondence or reprints contact: G. Lucignani, MD, INB-CNR, Dept. of Nuclear Medicine, University of Milan, c/o Institute H. San Raffaele, Via Olgettinga, 60, 1-20132 Milan, Italy.

ABSTRACT

Functional tissue heterogeneity, i.e., inclusion of tissues with different rates of blood flow and metabolism within a single region of interest, is an unavoidable problem with PET. Errors in determination of regional cerebral glucose utilization (rCMRglc) with [¹⁸F]FDG have resulted from the currently used simplifying assumption that all regions examined are homogeneous. We have established an optimal, yet practical procedure to minimize errors due to tissue heterogeneity in determination of rCMAglc. Effects of applying the three-rate constant kinetic model designed for homogeneous tissues with both dynamic and single-scan procedures and the Patlak plot were evaluated in normal subjects in experimental periods up to 120 min following tracer injection. The procedure with a singles can carried out anytime with in the interval between 60 and 120 min following tracer injection, combined with population average rate constants determined over a 120-min period, was found to be optimal for quantitative rCMRglc studies.

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