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Parameters influencing SPET regional brain uptake of technetium-99m hexamethylpropylene amine oxime measured by calibrated point sources as an external standard

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Abstract

Using calibrated point sources as an external standard to convert single-photon emission tomography (SPET) brain counts into absolute values of regional brain uptake (rBU) of technetium-99m hexamethylpropylene amine oxime (HMPAO), the relative contribution of different parameters to interindividual variability of cerebellar rBU was examined in 33 healthy volunteers. Stepwise regression analysis identified body surface as the most important factor underlying interindividual variability (P<0.001), when compared with brain volume. In the normal volunteer population presented, age decrement of rBU corrected for body surface and brain volume equalled 60.5–0.20×age. Based on the data of eight normal volunteers, including four test-retest studies with heart rate (HR) differences greater than 5 units and four test-stress studies with doubling of heart rate after bicycle exercise, influence of heart rate may be expressed by the equation ΔrBU=0.35 ΔHR. Clinically, estimation of the relative influence of different factors allows normalization and extension of the applicability of the rBU quantification method used from longitudinal studies to group comparisons. Interestingly, results of the Daily Stress Inventory Scale and a subjective rating scale suggest the absence of a significant influence of minor stress on rBU. When using one vial per patient, chromatography may be omitted in clinical routine practice and lipophilicity may be estimated as 90% of the injected dose, if administered within 10 min after preparation. Finally, sensitivity of the quantification method was tested in eight volunteers using acetazolamide brain activation and showed a mean increase in cerebellar rBU of 30.2%, varying between 14.1% and 75.9%.

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References

  1. Dobbeleir A, Dierckx RA. Quantification of technetium-99m hexamethylpropylene amine oxime brain uptake in routine clinical practice using calibrated point sources as an external standard: phantom and human studies. Eur J Nucl Med 1993; 20: 684–689.

    Google Scholar 

  2. Brantley PJ, Dietz LS, McKnight GT, Jones GN, Tulley R. Convergence between the daily stress inventory and endocrine measures. J Consult Clin Psychol 1988; 56: 549–551.

    Google Scholar 

  3. Brantley PJ, Waggoner CD, Jones GN, Rappaport NB. A daily stress inventory: development, reliability and validity. J Behav Med 1987; 10: 61–74.

    Google Scholar 

  4. Mah G, Reilly RM, Wong GLM, Houle S. A comparison of three methods to determine the radiochemical purity of Tc-99m hexamethylpropylene amine oxime (Tc-99m HMPAO). Nucl Med Commun 1989; 10: 733–740.

    Google Scholar 

  5. Syed G, Eagger S, Toone B, Levy R, Barrett JJ. Quantification of regional cerebral blood flow (rCBF) using Tc-99m HM-PAO and SPECT: choice of the reference region. Nucl Med Commun 1992; 13: 811–816.

    Google Scholar 

  6. Podreka I, Goldenberg G, Baumgartner C, Lang W Steiner M, Schmidbauer M, Suess E, Bruecke T, Asenbaum S, Deecke L. HMPAO brain uptake in young normal subjects: gender differences and hemispheric asymmetries (abstract). J Cereb Blood Flow Metab 1989; 9 Suppl 1: 202.

    Google Scholar 

  7. Verhoeff NPLG, Buell U, Costa DC, Kirsch G, Lottes G, Moretti JL, Podreka I, Schober O, van Royen EA. Basics and recommendations for brain SPECT. Nucl Med 1992; 31: 114–131.

    Google Scholar 

  8. Buell U, Schicha H. Nuclear medicine to image applied pathophysiology: evaluation of reserves by emission computerized tomography. Eur J Nucl Med 1990; 16: 129–135.

    Google Scholar 

  9. Tikofsky RS, Hellman RS. Brain single photon emission computed tomography: newer activation and intervention studies. Semin Nucl Med 1991; 21: 40–57.

    Google Scholar 

  10. Knop J, Thie A, Siepman G, Zeumer H. Tc-99m HMPAO-SPECT with acetazolamide challenge to detect hemodynamic compromise in occlusive cerebrovascular disease. Stroke 1992; 23: 1733–1742.

    Google Scholar 

  11. Hung JC, Corlija M, Volkert WA, Holmes RA. Kinetic analysis of technetium-99m d,l-HM-PAO decomposition in aqueous media. J Nucl Med 1988; 29: 1568–1576.

    Google Scholar 

  12. Neirinckx RD, Canning LR, Piper IM, Nowotnik DP, Picket RD, Holmes RA, Volkert WA, Forster AM, Weisner PS, Marriott JA, Chaplin SB. Technetium-99m d,l-HM-PAO. A new radiopharmaceutical for SPECT imaging of regional cerebral blood perfusion. J Nucl Med 1987; 28: 191–202.

    Google Scholar 

  13. Reba RC, Holman BL. Brain perfusion radiotracers. In: Diksic M, Reba RC, eds. Radiopharmaceuticals and brain pathology studied with PET and SPECT. Boston: CRC Press; 1991: 35–39.

    Google Scholar 

  14. Lequin MH, Blok D, Pauwels EKJ. Radiopharmaceuticals for functional brain imaging with SPECT. In: Freeman LM, ed. Nuclear medicine annual. New York: Raven Press; 1991: 37–65.

    Google Scholar 

  15. Nickel O, Nägele-Wöhrle B, Ulrich P, Eissner D, Roesler A, Grimm W, Hahn K. rCBF-quantification with Tc-99m HM-PAO SPECT: theory and first results. Eur J Nucl Med 1989; 15: 1–8.

    Google Scholar 

  16. Szabo Z, Monsein LK, Maruki, Jeffery PJ, van Heerden BB, Debrun G, Sostre S, Seki C, Natarajan TK, Wagner HN Jr, Camargo EE. Quantitative imaging of CBF with Tc-99m-HM-PAO. [abstract]. Eur J Nucl Med 1991; 18: 667.

    Google Scholar 

  17. Nakamura K, Tukatani Y, Kubo A, Hashimoto S, Terayama Y, Amano T, Goto F. The behavior of Tc-99m hexamethyl propylene amin oxime in blood and brain. Eur J Nucl Med 1989; 15: 100–107.

    Google Scholar 

  18. Matsuda H, Oba H, Seki H, Higashi S, Sumiya H, Tsuji S, Terada H, Imai K, Shiba K, Mori H, Hisada K. Determination of flow and rate constants in a kinetic model of Tc-99m hexamethylpropyleneamine oxime in the human brain. J Cereb Blood Flow Metab 1988; 8: 61–68.

    Google Scholar 

  19. Pupi A, De Cristofaro M, Bacciottini L, Antoniucci D, Formiconi AR, Mascalchi M, Meldolesi U. An analysis of the arterial input curve for technetium-99m-HMPAO: quantification of rCBF using single-photon emission computed tomography. J Nucl Med 1991; 32: 1501–1506.

    Google Scholar 

  20. Murase K, Tanada S, Fujita H, Sakaki S, Hamamoto K. Kinetic behavior of technetium-99m-HMPAO in the human brain and quantification of cerebral blood flow using dynamic SPECT. J Nucl Med 1992; 33: 135–143.

    Google Scholar 

  21. Matsuda H, Tsuji S, Shuke N, Sumiya H, Tonami N, Hisada K. A quantitative approach to technetium-99m hexamethylpropylene amine oxime. Eur J Nucl Med 1992; 19: 195–200.

    Google Scholar 

  22. Matusuda H, Tsuji S, Shuke N, Sumiya H, Tonami N, Hisada K. Noninvasive measurements of regional cerebral blood flow using technetium-99m-hexamethylpropylene amine oxime. Eur J Nucl Med 1993; 20: 391–401.

    Google Scholar 

  23. Ebmeier KP, Dougall NJ, Austin M-PV, Murray CL, Curran SM, O'Carroll R, Moffoot APR, Hannan J, Goodwin GM. The split-dose technique for the study of psychological and pharmacological activation with the cerebral blood flow marker exametazime and single photon emission computed tomography (SPECT): reproducibility and rater reliability. Int J Methods Psych Res 1991; 1: 27–38.

    Google Scholar 

  24. Horwitz B. Quantification and analysis of positron emission tomography metabolic data. In: Duara R, ed. Positron emission tomography in dementia. New York: Wiley-Liss; 1990; 2: 13–70.

    Google Scholar 

  25. Bonte FJ, Devous MD, Reisch JS. The effect of acetazolamide on regional cerebral blood flow in normal human subjects as measured by SPECT. Invest Radiol 1988; 23: 564–568.

    Google Scholar 

  26. Leinsinger G, Schmiedek P, Keisig T, Einhäupl K, Bauer W, Moser EA. 133-Xe-SPECT: Bedeutung der zerebrovaskulären Reservekapazität für Diagnostik und Therapie der chronischen zerebralen Ischdmie. Nucl Med 1988; 27: 127–134.

    Google Scholar 

  27. Lassen N, Andersen A, Friberg L, Paulson O. The retention of 99Tcm-d,I-HM-PAO in the human brain after intracarotid bolus injection: a kinetic analysis. J Cereb Blood Flow Metab 1988; 8 (Suppl): S13-S22.

    Google Scholar 

  28. Eagger S, Syed GMS, Burns A, Barrett JJ, Levy R. Morphologic (CT) and functional (rCBF-SPECT) correlates in Alzheimer's disease. Nucl Med Commun 1992; 13: 644–647.

    Google Scholar 

  29. Dierckx RA, Dobbeleir A, Martin JJ, de Deyn PP. Tc-99m HMPAO tomography using a three-headed SPECT system equipped with lead fanbeam collimators. Clin Nucl Med 1993; 18: 532–534.

    Google Scholar 

  30. Dormehl IC, Oliver DW, Hugo N. Dose response from pharmacological interventions for CBF changes in a baboon model using Tc-99m HMPAO and SPECT. Nucl Med Commun 1993; 14:573–577.

    Google Scholar 

  31. Sperling B, Lassen N. Hyperfixation of HMPAO in subacute ischemic stroke leading to spuriously high estimates of cerebral blood flow by SPECT. Stroke 1993; 24: 193–194.

    Google Scholar 

  32. Gur RC, Gur RE, Resnick SM, Brett E, Skolnick BE, Alavi A, Reivich M. The effect of anxiety on cortical cerebral blood flow and metabolism. J Cereb Blood Flow Metab 1987; 7: 173–177.

    Google Scholar 

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Authors and Affiliations

  1. Department of Nuclear Medicine, Middelheim Hospital, Lindendreef 1, B-2020, Antwerp, Belgium

    R. A. Dierckx, A. Dobbeleir & A. Vervaet

  2. Department of Neurology, Middelheim Hospital, Lindendreef 1, B-2020, Antwerp, Belgium

    B. A. Pickut & P. P. De Deyn

  3. Laboratory of Neurochemistry and Behavior, Born-Bunge Foundation UIA, University of Antwerp, Universiteitsplein 1, B-2610, Antwerp, Belgium

    P. P. De Deyn

  4. Department of Psychiatry, University Hospitals of Cleveland, Abington Road 2040, 4406, Cleveland, OH, USA

    M. Maes

Authors
  1. R. A. Dierckx
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  2. A. Dobbeleir
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  5. A. Vervaet
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Dierckx, R.A., Dobbeleir, A., Maes, M. et al. Parameters influencing SPET regional brain uptake of technetium-99m hexamethylpropylene amine oxime measured by calibrated point sources as an external standard. Eur J Nucl Med 21, 514–520 (1994). https://doi.org/10.1007/BF00173038

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  • DOI: https://doi.org/10.1007/BF00173038

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