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Quantification of Regional Cerebral Blood Flow with Continuous Infusion of Technetium-99m-Ethyl Cysteinate Dimer

Department of Radiology and Biomedical Imaging Research Center, Fukui Medical School, Fukui
Department of Nuclear Medicine, Kyoto University Faculty of Medicine, Kyoto, Japan

Correspondence: For correspondence or reprints contact: Tatsuro Tsuchida, MD, Department of Radiology, Fukui Medical School, 23 Shimoaizuki, Matsuoka-cho Yoshida-gun, Fukui 910-11, Japan.

ABSTRACT

We proposed new method to quantify regional cerebral blood flow (rCBF) with continuous infusion of ^99mTc-ethyl cysteinate dimer (ECD) and dynamic SPECT. Methods: Thirteen subjects were studied. Seven subjects had SPECT and PET studies, and the other six subjects were involved in the measurement of blood clearance of ^99mTc-ECD. During constant infusion of ^99mTc-ECD (740 MBa.) over 10 mm, dynamic SPECT scans were obtained every 1 mm by means of a triple-head rotating SPECT camera. Intermittent arterial blood sampling with octanol extraction was performed every 1 mm to estimate the arterial input function. In flux constant (Ku) obtained by Gjedde-Patlak graphical plot method was compared with rCBF measured by PET using ¹⁵O CO₂ steady state method. In order to simplify the procedure, arterial input function in each subject was estimated by calibration of the arterial blood sampled at the end of the scan to the standard arterial input function estimated from the blood clearance rate in six subjects. Results: Ku was linearly correlated with rCBF (Ku = 0.09 + 0.62 rCBF, r = 0.85, p < 0.05). Ku calculated with the estimated input function (Ku') and rCBF also demonstrated a linear relationship (Ku' = 0.05 + 0.65 rCBF, r = 0.84, p ± 0.05). Conclusion: The proposed method with one-point arterial sampling is a simple, clinically feasible tool for quantitative measurementof rCBF with ^99mTc-ECD.

Key Words: continuous infusion • dynamic SPECT • technetium-99m-ECD • graphical plot cerebral blood flow • quantification

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