Rapid calculation of regional cerebral blood flow and distribution volume using iodine-123-iodoamphetamine and dynamic SPECT.

Abstract

Iodine-123-iodoamphetamine (IMP) is commonly used as a flow tracer for SPECT due to its large first-pass extraction fraction. Significant clearance from the brain, however, causes changes in distribution and underestimation of CBF values when a conventional microsphere model is applied to prolonged data acquisition. We have developed a rapid method to calculate CBF images in which clearance effects are taken into account. A dynamic SPECT scan was obtained from five subjects (four patients with cerebral infarctions and one healthy volunteer) following intravenous injection of IMP lasting 1 min. The arterial input function was obtained by frequent blood sampling and measurement of the octanol extraction ratio. The dynamic images were weighted and integrated so that the look-up table procedures yielded values of CBF and distribution volume (Vd) simultaneously. Calculated values for CBF and Vd were consistent with those determined by nonlinear least squares fitting [CBF: Y = 1.03X-0.30 (ml/100 ml/min), r = 0.998, p < 0.001; Vd: Y = 0.99X-0.11 (ml/ml), r = 0.99, p < 0.001] and calculated CBF correlated significantly with CBF measured by PET [Y = 0.85X-0.15 (ml/100 ml/min), r = 0.92, p < 0.001]. This technique is valid for estimating CBF.