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SPECT and Planar Brain Imaging in Crack Abuse: Iodine-123-Iodoamphetamine Uptake and Localization

Medical Department, Brookhaven National Laboratory, Upton, New York
Department of Radiology, Health Science Center, State University of New York, Stony Brook, New York

Correspondence: For correspondence or reprints contact: David A. Weber, PhD, Medical Department, Brookhaven National Laboratory, Upton, NY.

ABSTRACT

The uptake, distribution, and clearance properties of ¹²³I-IMP in the brain were evaluated in controls and asymptomatic crack users to investigate cerebral blood flow alterations in crack abuse. Serial dynamic planar images of the brain (0–25 min), SPECT of the brain (0.5 hr and 4 hr) and whole-body scans (75 min) were obtained in 21 crack abusers and 21 control subjects. Major observations include: (a) foci of abnormally reduced ¹²³I-IMP activity mainly in the frontal and parieto-occipital cortex or marked irregularities in the uptake of ¹²³I-IMP throughout the cerebral cortex consistent with moderate to severe disruption in regional cerebral blood flow were observed on the 0.5 hr SPECT images of 16/21 asymptomatic crack users; (b) no correlation could be demonstrated between the incidence or severity of SPECT perfusion abnormality with the frequency, amount or length of time of crack use; (c) focal perfusion defects observed in 6/21 crack users on the 0.5-hr SPECT images partially or completely filled-in on delayed SPECT at 4 hr in four of six subjects; (d) the rate of cerebral uptake of ¹²³I-IMP in crack users averaged 23% less than observed in control subjects over the first 25 min after tracer administration; and (e) ¹²³I-IMP activity reaching the brain of cigarette smoking control subjects (n = 14) at 25 min after injection averaged 42.5% less than in nonsmoking controls (n = 7). Quantitative measurements of the uptake and distribution properties of ¹²³I-IMP in the brain proved to be an objective, sensitive and useful measure of regional cerebral blood flow in crack abuse.

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