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Basic Science Investigation |
1 Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, California; 2 Crump Institute for Molecular Imaging, David Geffen School of Medicine at UCLA, University of California, Los Angeles, California; and 3 Division of Neurosurgery, David Geffen School of Medicine at UCLA, University of California, Los Angeles, California
Correspondence: For correspondence or reprints contact: Heinrich R. Schelbert, MD, PhD, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Box 956948, B2-085J CHS, 10833 Le Conte Ave., Los Angeles, CA 90095-6948. E-mail: hschelbert{at}mednet.ucla.edu Guest Editor: Frank Bengel
| ABSTRACT |
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Key Words: cardiac output microPET cardiovascular mouse dynamic
| INTRODUCTION |
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| MATERIALS AND METHODS |
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Animals and Imaging Protocol
Twenty-five 10- to 24-wk-old male CL57BL/6 mice (28.8 ± 4.6 g) were studied. Anesthesia was induced by inhalation of 1.5%2% isoflurane in 100% oxygen. The animals were placed in an imaging chamber specifically designed for small-animal PET and small-animal CT studies (17) to allow for temperature control and monitoring, reproducible positioning, and anesthesia delivery. A 29-gauge needle connected to a 3- to 5-cm-long polyethylene catheter (PE20; Intramedic, Clay-Adams) was inserted into the tail vein for radiotracer injection and for drug administration. 18F-FDG (30 µL, 844 MBq) was injected manually within less than 1 s and without an additional saline flush. Heart rates were monitored electrocardiographically.
Measurements were repeated in 5 mice as often as 4 times but at least 2 d apart to allow sufficient time for the animals to recover. For the pharmacologic intervention studies, 4 mice were studied twice, first at baseline and then again shortly after infusion of dobutamine. The agent is known to increase cardiac output significantly in mice (18,19). The dobutamine (12.5 mg/mL; Ben Venue Laboratories, Inc.) was diluted in normal saline solution and infused intravenously with an infusion pump through the tail vein catheter. Beginning with 6 µg of dobutamine/min/kg of body weight, the infusion rate was increased in steps of 6 µg/min/kg every 2 min until a rate of 24 µg/min/kg was reached. That rate was maintained for at least 3 min. Immediately after the dobutamine infusion had been discontinued, the 30 µL bolus of 18F-FDG was injected through the tail vein. The 110-min half-life of 18F precluded performance of baseline and dobutamine studies during the same study session. Therefore, the animals were allowed to recover after the baseline study for at least 2 d, after which the dobutamine stimulation studies were performed. For the same reason, reproducibility measurements were performed on separate days.
Electrocardiograms were recorded with 2 neonatal carbon electrodes (3M Health Care) attached to the shaved upper right and lower left back of the mouse and connected to a multichannel amplifying and analyzing system (MP 150; Biopac Systems, Inc.) and a laptop computer (iMac; Apple Computer, Inc.) (20).
Small-Animal PET
A microPET Focus 220 system (Siemens Preclinical Solutions) was used. The body of a mouse fits in the axial field of view of 7.6 cm. The sensitivity of the system is 3.4% at the center of the field of view, and the spatial resolution with filtered backprojection reconstruction approaches 1.75 mm in full width at half maximum (21). Data were corrected for radioactive decay, random coincidence counts, and dead-time losses.
The 10-min list-mode image acquisition was started 14 s before the 18F-FDG bolus injection. After image acquisition, the animal bed with the mouse positioned inside was transferred to a small-animal CT scanner (microCAT II; Siemens Preclinical Solutions) used to generate CT-derived attenuation maps for correction of the PET data (22). Special care was taken to prevent any movement of the mouse on the bed during the switch from PET to CT. After image reconstruction, the small-animal PET and small-animal CT studies were coregistered using a previously published method in which a known translational offset can be applied to align the images (22). Alignment accuracy between the PET and CT images was also monitored and verified visually.
Image Reconstruction
The first 9 s of list-mode data after radiotracer injection were binned into 30 frames of 0.3 s each. An attenuation map was generated from the acquired small-animal CT dataset (22). PET data were reconstructed using the filtered backprojection algorithm with a pixel size of 0.4 mm and an interplane distance and thickness of 0.8 mm in a 128 x 128 matrix with 95 transverse slices. Scatter and attenuation correction was applied (microPET Manager, version 2.1.5.0; Siemens Preclinical Solutions).
Analysis of PET Data
For image display and assignment of volumes of interest (VOIs), the public domain program AMIDE was used (23). Three-dimensional cylindric and elliptic VOIs were placed in the right ventricle (RV) and LV based on the first-pass images, and over the whole body of the mouse using all views: transverse, coronal, and sagittal. The VOIs were then copied to the rebinned, serial 0.3-s frames of the first 9 s after tracer injection. Proper positioning was verified visually. VOIs were 1.3 mm3 for the RV and 2.6 mm3 for the LV for all animals. Depending on the angulation of the heart relative to the imaging planes, the VOIs extended over 23 imaging planes. Three-dimensional volume, rather than 2-dimensional planar regions of interest were used to obtain better count statistics. Late-phase images were not used for VOI assignment because only early-phase data, from the first passage of the radiotracer through the circulatory system, were required for this study. Counts derived from the VOIs were expressed as mean PET counts/cm3/s and were used for generating timeactivity curves. The whole-body activity derived from the whole-body VOI was expressed as counts/s.
The cardiac output was calculated by the Stewart-Hamilton indicator-dilution method (2426), in which blood flow through a vessel (or cardiac output) is derived from the integral of the first-pass indicator (or radiotracer) concentration curve and the amount of indicator (or radiotracer) introduced into the blood vessel by
![]() | (Eq. 1) |
The injected dose of radiotracer A was assumed to equal the counts in the whole-body VOI (PET counts/min). The radiotracer concentration in the blood during the initial bolus transit was derived from the LV timeactivity curve corrected for the partial-volumerelated underestimation of the true activity and is expressed in counts/s/mL. The downslope of the timeactivity curve was fitted exponentially and extrapolated over 8 s to remove contamination by recirculating activity from the tail end of the timeactivity curve (Fig. 1). The integral of the first-pass radiotracer timeactivity curve was then expressed as the product of counts/s/mL and time t.
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The recovery coefficient for this study was determined by setting the value for the blood pool of the 4-dimensional phantom to 100 arbitrary units and the values for other structures to zero. A heart rate of 460 beats/min and respiratory rate of 150 breaths/min, reflecting normal values for mice, were simulated. The image data of the animal's chest were reconstructed into 75 slices using a voxel size of 0.2 mm and a transaxial matrix size of 128 x 128. In order to account for the lower resolution of small-animal PET, a Gaussian filter (1.75 mm in full width at half maximum) was applied to the 3-dimensional dataset. The recovery coefficient was determined by placing the same-sized VOI as was used for the mouse studies on the LV blood pool of the phantom image data. In this way, a recovery coefficient of 0.76 was obtained and subsequently applied to the count activities derived from the LV blood-pool VOI.
The cardiac index was derived from cardiac output divided by body weight and stroke volume by dividing cardiac output by heart rate as determined from the electrocardiogram.
Comparison of In Vivo PET-Derived Blood-Pool Counts with Blood Sampling
In 6 additional mice, a polyethylene catheter (PE10; Intramedic, Clay-Adams) was inserted under isoflurane anesthesia into the femoral artery. Multiple blood samples (<15 µL) were obtained manually during the 1-h PET study. The counts, measured by a high
-counter (Packard Cobra II Auto Gamma; Perkins Elmer Inc.), were corrected for dead time, scatter, and decay and were then converted to PET-equivalent counts/mL using a calibration factor derived from a mouse-sized cylinder.
Because blood samples could not be obtained rapidly enough to determine the radioactivity concentrations during the initial bolus transits through the central circulation, we selected an early time point, 2035 s after injection, for the comparison between in vivo and blood-samplingderived values. At this time, equivalent to several circulation times, the 18F-FDG concentration is relatively constant and 18F-FDG uptake in the myocardium is still minimal. Assignment of VOIs in this group of mice was the same as in the cardiac output group. The mean counts detected by the LV blood-pool VOI were corrected for partial volume using the previously determined recovery coefficient of 0.76 and were compared with the arterial blood-sampling data.
Data Analysis
Mean values are given with SD. Linear regression analysis was used for correlating cardiac output, cardiac index, stroke volume, and heart rate. The variability of the repeated measurements was expressed as the ratio of the SD to the mean value of all measurements (percentage SD). A paired 2-tailed Student t test was used for comparing the baseline and dobutamine-stress measurements and then again for the repeated measurements in the same mouse. A P value of less than 0.05 indicated statistical significance.
| RESULTS |
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Cardiac Output, Cardiac Index, and Stroke Volume
Cardiac output at baseline averaged 20.4 ± 3.4 mL/min in the 25 mice studied, and the average cardiac index was 0.73 ± 0.19 mL/min/g. Heart rate positively correlated with both cardiac output and cardiac index (respectively, r = 0.53, P = 0.007, and r = 0.49, P = 0.01; Fig. 4). The stroke volume averaged 45.0 ± 6.9 µL.
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The percentage SDs normalized to the mean cardiac output, cardiac index, and stroke volume were 10% ± 6%, 8% ± 5%, and 4% ± 2%, respectively (Fig. 5), when all measurements, up to 4 per mouse, were included. The heart rate displayed a mean percentage SD of 13% ± 9%.
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| DISCUSSION |
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Technical Considerations
Rebinning of the list-mode image data into only 0.3 s image frames produced several images that clearly depicted the first transit of the radiotracer through the central circulation in mice. Radiotracer activities as high as 44 MBq or as low as 8 MBq of 18F-FDG yielded images of good diagnostic quality and concurrently allowed the generation of first-pass radiotracer blood concentration curves for the RV and LV.
Instead of reconstructing the images with the maximum a posteriori algorithm (28,29), we used filtered backprojection in the current study, for 2 reasons: First, reconstruction of 30 serial image sets is computationally highly intensive and requires less time with filtered backprojection than with iterative algorithms. Second, the spatial resolution achieved with filtered backprojection was adequate in the current study. As evident on the serial images, there was relatively little cross contamination of radioactivity between the RV and the LV timeactivity curves.
Critical for the measurement of cardiac output in the current study were the amount of radiotracer injected and the radiotracer concentrations in blood. Different from the standard approach of determining the injected radioactivity in a dose calibrator, the total injected radioactivity was determined in the current study from the whole-body counts derived from the cylindric VOI covering the entire 7.6-cm-long field of view of the small-animal PET scanner and thus the whole body of the mouse. The maximum activity recorded within the first 24 s after radiotracer injection reflected the tracer activity delivered into the circulation and was used as the estimate of the total injected dose. By using this approach, we eliminated the need for corrections of residual activity in the intravenous injection system or for conversion of well counterderived ex vivo counts into PET counts.
In some studies, we observed that whole-body activity continued to increase, though only slightly, after the early "plateau." This increase was most likely related to radiotracer infiltration at the site of the tail vein injection. Because the tail of the mouse was outside the field of view, this activity was registered by the whole-body VOI only after its release from soft tissue into the circulation. Because cardiac output was determined from the amount of radiotracer injected into the vascular system at the time of the initial bolus transit, the delayed rise in total recorded activity was unlikely to have affected the measurements.
Determination of the radiotracer concentrations in blood during the bolus transit required correction for partial-volumerelated underestimation. This correction can be achieved through measurements of the LV via echocardiography or MRI. Cardiac and respiratory motion, however, limits the accuracy of these measurements for partial-volume correction. The recovery coefficient was therefore estimated in the current study from a 4-dimensional phantom that accounts for cardiac and respiratory motion and that simulated the "effective" partial volume in a 16-wk-old male C57BL/6 mouse. Because heart volumes tend to vary only slightly among adult mice older than 2 mo (30), the application of the phantom-derived recovery coefficients to the animals in the current study seems justified. The close agreement between the in vivo PET-measured blood concentrations and the ex vivomeasured blood concentrations supports the validity of the phantom-based corrections of LV blood-pool activity for partial volume.
The procedure and measurements are independent of the radiolabeled compound injected; therefore, any imaging probe could potentially be used to obtain these measurements. Other isotopes, with a greater positron range (such as 11C or 13N), or with multiple emission characteristics (such as 124I or 64Cu), could potentially be used. Further investigations are warranted on the effect on the quantitative data of using isotopes with a greater positron range to decrease image resolution. When repeated injections of isotopes with a physical half-life shorter than that of 18F were used, the variability of measurements could be determined in a single imaging session.
Parameters of Cardiovascular Function
Although the estimates of cardiac output and stroke volume were not independently validated in this study, they were consistent with those derived from gated MRI in the same strain of animals of similar body weight (19). Cardiac output and stroke volumes in those studies averaged 19.1 ± 1.1 mL/min and 40.0 ± 2.2 µL, as compared with 20.4 ± 3.4 mL/min and 45.0 ± 6.9 µL in the current study. They were, however, higher than those in other MRI investigations or in studies using intraventricular conductance catheters and flow probes (18,30,31). Besides being related to differences in body weight, strain of animals, and anesthesia, the lower values in those studies may have been related also to the invasiveness of intraventricular conductance catheters and perivascular flow probes.
An important aspect of the current study is the reproducibility of the measurements of cardiac output and stroke volumes, which is important for long-term longitudinal studies. Because of the 110-min physical half-life of 18F, measurements could not be repeated in same study session but were repeated 214 d later. The observed differences between measurements included both measurement errors and changes in the physiologic state of the animals as indicated by differences in heart rate. When the cardiac output was normalized for heart rate, the resulting stroke volumes varied less. The stroke volume displayed a mean percentage SD of only 4%, compared with a 10% SD for cardiac output, indicating a significant influence of heart rate variability on the variability in measurements of cardiac output. When the different physiologic conditions of the animals were considered, the measurement variability of cardiac output and index was acceptable and in the range of echocardiography in mice (32).
Infusion of dobutamine in the current study raised the cardiac output by an average of 74% ± 25% from baseline. This increase was considerably higher than the 37.5% increase observed by Gao et al. (18) by perivascular flow probe. This lower increase in cardiac output might be explained by a lower dobutamine dose of only 18 µg/kg of body weight intravenously over 60 s. Also, the lower dose led to a lower increase in heart rate, from 417 ± 11 to 518 ± 15 per minute, or 24%, as compared with 43% in this study. The use of a type of anesthesia different from that used in our study may also have played a role.
Wiesmann et al. (19) found a 24% increase in cardiac output as determined by MRI and a 33% increase in heart rate after intraperitoneal injection of a relatively high dose of 1,500 µg/g. Here, the bioavailability of dobutamine and the effect of high amounts of dobutamine on adrenergic receptors other than ß1 remain unclear. Using an administration protocol similar to that in this study, with a maximum dose of 24 µg/min/kg of body weight, Naumova et al. (33) found a similar 39% increase in heart rate from baseline to stress. The cardiac output was not determined.
| CONCLUSION |
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| ACKNOWLEDGMENTS |
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| References |
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This article has been cited by other articles:
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G. Z. Ferl, X. Zhang, H.-M. Wu, and S.-C. Huang Estimation of the 18F-FDG Input Function in Mice by Use of Dynamic Small-Animal PET and Minimal Blood Sample Data J. Nucl. Med., December 1, 2007; 48(12): 2037 - 2045. [Abstract] [Full Text] [PDF] |
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