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A Comparative Study of Simple Methods to Measure Regional Cerebral Blood Flow Using Iodine-123-IMP SPECT

Department of Radiological Technology, College of Biomedicai Technology, Niigata University, Niigata; Department of Radiology and Department of Psychiatry, Niigata University School of Medicine, Niigata, Japan

Correspondence: For correspondence or reprints contact: Masaki Ohkubo, Dept. of Radiological Technology, College of Biomedicai Technology, Niigata University, 2-746 Asahimachidohri, Niigata 951, Japan.

ABSTRACT

The aim of this study was to compare the accuracy and reliability of simple methods of quantifying regional cerebral blood flow (rCBF) with ¹²³I-labeled N-isopropyl-p-lodoamphetamine (IMP) and SPECT and to determine which method was best. Methods: Four methods were examined: (a) the microsphere method with continuous withdrawal of arterial blood, which was based on a microsphere model using the SPECT image obtained 5 min after tracer injection, (b) the microsphere method with one-point sampling, which was the same as the first method except that one-point sampling, was used instead of continuous withdrawal, (c) the modified microsphere method with one-point sampling, which was the same as the second method except that a later SPECT image (30-min postinjection) with correction was used and (d) a table look-up method based on a two-compartment model with one-point arterial blood sampling and two SPECT scans obtained 40- and 180-min postinjection. The accuracy of these methods was validated by comparing the rCBF values with those obtained by nonlinear least squares fitting analysis based on the two-compartment model in 15 subjects. Results: Regional cerebral blood flow values obtained by the first method correlated most closely with those obtained by nonlinear least squares fitting analysis (error,6.8%). The second method estimated rCBF with a mean error of 10.4%. The third method estimated rCBF with a mean error of 13.1%, even though it tended to slightly overestimate rCBF. The fourth method was inclined to underestimate rCBF with a mean error of 17.1%, and it greatly overestimated regional distribution volume. Conclusion: The first method was the most accurate and reliable. For less invasiveness, the first method should be combined with one-point sampling instead of continuous withdrawal, which was used in the second method. When using a delayed SPECT image with a conventional SPECT scanner, the third method was considered to be superior to the fourth method.

Key Words: iodine-123-IMP • regional cerebral blood flow • SPECT • microsphere model • two-compartment model

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