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Regional Cerebral Blood Flow Measurement with Iodine-123-IMP Autoradiography: Normal Values, Reproducibility and Sensitivity to Hypoperfusion

Department of Radiology and Nuclear Medicine, Akita Research Institute of Brain and Blood Vessels, Akita, Japan

Correspondence: For correspondence or reprints contact: Jun Hatazawa, MD, PhD, Department of Radiology and Nuclear Medicine, Akita Research Institute of Brain and Blood Vessels, 6-10 Senshu-Kubota Machi, Akita 010, Japan.

ABSTRACT

We recently proposed a simplified technique for measuring regional cerebral blood flow (rCBF) using the [¹²³I]N-isopropyl-p-iodoamphetamine (IMP) autoradiographic (ARG) method with SPECT (the IMP-ARC method). We examined normal values of rCBF and the reproducibility and sensitivity to hypoperfusion in stroke patients using this method. Methods: By using a standard arterial input, a single static scan, a fixed distribution volume (V_d) and one-point arterial blood sampling, we measured rCBF in 39 normal volunteers (19 men and 20 women; mean ages 61 ± 11 yr for the men and 60 ± 12 yr for the women). Eighteen neurologically stable patients with prior stroke (mean age = 65 ± 11 yr) were studied twice at a mean interval of 97 days. In 16 patients (7 men and 9 women, mean age = 63 ± 5 yr) with subarachnoid hemorrhage, rCBF was measured 1–2 wk after onset. Cerebral vasospasm was evaluated by repeated angiography. The mean rCBF in the vasospastic area was compared with that in a nonvasospastic area. Results: The mean rCBFs of the cerebral cortex and centrum semiovale in the volunteers were 33.0 ± 5.1 ml/100 g/min and 25.0 ± 4.5 ml/100 g/min, respectively. There was no age-dependent change in rCBF, but the women showed significantly higher cortical rCBF than the men (p <0.05). In the stroke patients, the whole-brain CBF values showed high reproducibility, with high correlations between those obtained at the first and second studies (y = –3.5 + 1.03x; r = 0.90; p < 0.001). In the subarachnoid hemorrhage patients, the vasospastic area showed significantly lower rCBF than the normal cortical rCBF (p < 0.01) and the nonvasospastic area (p < 0.01). Brain regions with rCBF levels below 20 ml/100 g/min showed infarction on the follow-up CT scan. Conclusion: The IMP-ARG method is reproducible, sensitive to hypoperfusion and feasible for the quantitative evaluation of rCBF in routine clinical practice.

Key Words: SPECT • iodine-123-IMP • cerebral blood flow • cerebral infarction • subarachnoid hemorrhage

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