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Research ArticleClinical Investigations

Quantification of Dynamic 11C-Phenytoin PET Studies

Syahir Mansor, Ronald Boellaard, Femke E. Froklage, Esther D.M. Bakker, Maqsood Yaqub, Rob A. Voskuyl, Lothar A. Schwarte, Joost Verbeek, Albert D. Windhorst and Adriaan Lammertsma
Journal of Nuclear Medicine September 2015, 56 (9) 1372-1377; DOI: https://doi.org/10.2967/jnumed.115.158055
Syahir Mansor
1Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
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Ronald Boellaard
1Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
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Femke E. Froklage
2Department of Neurology, Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands; and
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Esther D.M. Bakker
1Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
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Maqsood Yaqub
1Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
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Rob A. Voskuyl
2Department of Neurology, Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands; and
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Lothar A. Schwarte
3Department of Anaesthesiology, VU University Medical Center, Amsterdam, The Netherlands
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Joost Verbeek
1Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
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Albert D. Windhorst
1Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
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Adriaan Lammertsma
1Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
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  • FIGURE 1.
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    FIGURE 1.

    Typical 11C-phenytoin activity concentration images obtained in healthy subject, averaged over several early frames (30–90 s after injection) (A) and late frames (45–60 min after injection) (B).

  • FIGURE 2.
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    FIGURE 2.

    Example of decay-corrected time–activity curves of 11C-phenytoin for several brain regions in healthy subject.

  • FIGURE 3.
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    FIGURE 3.

    Mean and SD (error bar) of parent and polar fractions, plasma–to–whole-blood ratio (P/WB), and HPLC metabolites obtained from manual blood samples.

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    FIGURE 4.

    TRT variability of K1 (A) and VT (B) for each subject for small (<5 mL) and large (>5 mL) region-of-interest volumes.

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    FIGURE 5.

    Bland–Altman plots of K1 (A–C) and VT (D–F) test–retest data for 60- (A and D), 45- (B and E), and 30- (C and F) min scan durations. ○ = 60-min scan duration data; □ = 45-min scan duration data; △ = 30-min scan duration data; bold line = mean difference between test and retest.

  • FIGURE 6.
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    FIGURE 6.

    TRT variability of K1 (A) and VT (B) for each subject and for different scan durations.

Tables

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    • View popup
    TABLE 1

    Preference Frequency (%) According to Akaike Information Criteria for Small (<5 mL) and Large (>5 mL) VOI Sizes

    Akaike frequency (%)
    ModelVOI < 5 mLVOI > 5 mL
    1T2k0.00.0
    1T2k + Vb31.342.2
    2T3k0.00.0
    2T3k + Vb4.613.8
    2T4k0.00.0
    2T4k + Vb4.93.2
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    TABLE 2

    TRT Variabilities for K1 and VT for Each Individual Subject, Given as Average (±SD) Percentage Repeatability Across All VOIs

    SubjectK1 TRTVT TRT
    14.10 ± 4.722.23 ± 4.62
    20.83 ± 5.98−3.15 ± 6.95
    38.76 ± 4.501.53 ± 6.01
    4−6.13 ± 7.71−3.42 ± 6.78
    5−17.6 ± 7.24−2.99 ± 13.8
    66.51 ± 4.44−2.46 ± 3.70
    Average ± SD−0.59 ± 10.73−1.38 ± 8.00
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    TABLE 3

    Summary of Correlation Parameters Between Data from Different Scan Durations (45 and 30 Minutes) Versus 60 Minutes

    K1VT
    TestRetestTestRetest
    Scan durationSlopeR2SlopeR2SlopeR2SlopeR2
    45 vs. 60 min1.000.981.000.981.000.841.000.90
    30 vs. 60 min1.020.971.000.980.980.760.990.86
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    TABLE 4

    Comparison of Some Kinetic Parameters for 11C-Phenytoin, (R)-11C-Verapamil, and 11C-dLop

    Pgp substrateK1 (mL·mL−1·min−1)k2 (min−1)VT (mL·mL−1)
    11C-phenytoin (n = 6)*†0.037 ± 0.0080.042 ± 0.0090.881 ± 0.126
    (R)-11C-verapamil (n = 5)‡0.036 ± 0.0090.102 ± 0.0030.660 ± 0.123
    11C-dLop (n = 6)*0.014 ± 0.0010.012 ± 0.0021.169 ± 0.149
    • ↵* Obtained using 1T2k + Vb model.

    • ↵† Pooled over whole-brain region across all subjects.

    • ↵‡ Obtained using 2T4k model.

    • Data are mean ± SD.

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Journal of Nuclear Medicine: 56 (9)
Journal of Nuclear Medicine
Vol. 56, Issue 9
September 1, 2015
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Quantification of Dynamic 11C-Phenytoin PET Studies
Syahir Mansor, Ronald Boellaard, Femke E. Froklage, Esther D.M. Bakker, Maqsood Yaqub, Rob A. Voskuyl, Lothar A. Schwarte, Joost Verbeek, Albert D. Windhorst, Adriaan Lammertsma
Journal of Nuclear Medicine Sep 2015, 56 (9) 1372-1377; DOI: 10.2967/jnumed.115.158055

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Quantification of Dynamic 11C-Phenytoin PET Studies
Syahir Mansor, Ronald Boellaard, Femke E. Froklage, Esther D.M. Bakker, Maqsood Yaqub, Rob A. Voskuyl, Lothar A. Schwarte, Joost Verbeek, Albert D. Windhorst, Adriaan Lammertsma
Journal of Nuclear Medicine Sep 2015, 56 (9) 1372-1377; DOI: 10.2967/jnumed.115.158055
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Keywords

  • 11C-Phenytoin
  • PET quantification
  • kinetic modeling
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