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Clinical Application and Quantitative Evaluation of Generator-Produced Copper-62-PTSM as a Brain Perfusion Tracer for PET

Departments of Nuclear Medicine, Brain Pathophysiology and Radiopharmaceutical Chemistry, Kyoto University, Kyoto, Japan

Correspondence: For correspondence or reprints contact: Hidehiko Okazawa, MD, Department of Nuclear Medicine, Kyoto University School of Medicine, 54 Shogoin Kawaharacho, Sakyo-ku, Kyoto 606-01, Japan.

ABSTRACT

Copper-62-pyruvaldehyde bis(N⁴-methylthiosemicarbazone) copper II (⁶²Cu-PTSM) has been proposed as a generator-produced positron-emitting tracer for perfusion imaging. To evaluate the characteristics of ⁶²Cu-PTSM as a cerebral perfusion tracer, brain PET images of ⁶²Cu-PTSM were compared with cerebral blood flow (CBF). Methods: Following an intravenous injection of ⁶²Cu-PTSM, a serial dynamic PET scan was performed for 10 min with arterial sampling in 10 subjects. CBF was measured by ¹⁵O-labeled water before the ⁶²Cu-PTSM study. Results: Dynamic PET scan with octanol-extracted arterial input function indicated the presence of significant back-diffusion of ⁶²Cu-PTSM from the brain within 3 min after injection, followed by stable activity from 3 to 10 min. Comparison with ¹⁵O-water PET demonstrated less contrast between high- and low-flow regions in ⁶²Cu-PTSM image and a nonlinear relationship of flow and ⁶²Cu-PTSM uptake, which suggests the underestimation of CBF in high-flow regions due to the existence of back-diffusion. Conclusion: Although ⁶²Cu-PTSM can be used widely for evaluation of brain perfusion with PET, kinetic analysis and correction may be needed to quantify regional CBF.

Key Words: copper-62-PTSM • PET • cerebral blood flow • perfusion tracer

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