Evaluation of utility of asymmetric index for count-based oxygen extraction fraction on dual-tracer autoradiographic method for chronic unilateral brain infarction

: Iwanishi K, Watabe H, Fujisaki H, Hayashi T, Miyake Y, Minato K, Naganuma M, Uehara T, Yokota C, Moriwaki H, Kajimoto K, Fukushima K, Minematsu K, Iida H

Publisher: SPRINGER

: 2009

: Annals of Nuclear Medicine

: ANNALS OF NUCLEAR MEDICINE

: ANN NUCL MED

: 23

: 6

: 533

: 539

: 7

: 0914-7187

DOI: https://doi.org/10.1007/s12149-009-0272-2

For diagnosing patients with ischemic cerebrovascular disease, non-invasive count-based method with (15)O(2) and H (2) (15) O positron-emission tomography (PET) data is widely used to measure asymmetric increases in oxygen extraction fraction (OEF). For shortening study time, we have proposed dual-tracer autoradiographic (DARG) protocol in which (15)O(2) gas and C(15)O(2) gas are sequentially administrated within short period. In this paper, we evaluated feasibility of the non-invasive count-based method with the DARG protocol.Twenty-three patients [67.8 +/- A 9.9 (mean +/- A SD) years] with chronic unilateral brain infarction were examined by the use of measurements of asymmetric OEF elevation. As DARG protocol, (15)O(2) and C(15)O(2) gases were inhaled with 5-min interval and dynamic PET data were acquired for 8 min. Quantitative OEF (qOEF) image was computed with PET data and arterial input function. Ratio image of (15)O(2) and C(15)O(2) phases of PET data was computed as count-based OEF (cbOEF) image. The asymmetric indices (AI) of qOEF (qOEF-AI) and cbOEF (cbOEF-AI) were obtained from regions of interest symmetric placed on left and right sides of cerebral hemisphere. To optimize the summation time of PET data for the cbOEF image, qOEF and cbOEF images with various summation times were compared.Image quality of cbOEF image was better than that of qOEF image. The best correlation coefficient of 0.94 was obtained when the cbOEF image was calculated from 0 to 180 s of (15)O(2) summed image and 340 to 440 s of C(15)O(2) summed image.Using the appropriate summation time, we obtained the cbOEF image with good correlation with qOEF image, which suggests non-invasive cbOEF image can be used for evaluating the degree of misery perfusion in patients with chronic unilateral brain infarction. The count-based method with DARG protocol has a potential to dramatically reduce the examination time of (15)O PET study.