Objective: Cerebral blood flow (CBF), cerebral metabolic rate of oxygen (CMRO2), oxygen extraction fraction (OEF), and cerebral blood volume (CBV) are quantitatively measured with PET with 15O gases. Kudomi et al. developed a dual tracer autoradiographic (DARG) protocol that enables the duration of a PET study to be shortened by sequentially administrating 15O2 and C15O2 gases. In this protocol, before the sequential PET scan with 15O2 and C15O2 gases (15O2-C 15O2 PET scan), a PET scan with C15O should be preceded to obtain CBV image. C15O has a high affinity for red blood cells and a very slow washout rate, and residual radioactivity from C 15O might exist during a 15O2-C 15O2 PET scan. As the current DARG method assumes no residual C15O radioactivity before scanning, we performed computer simulations to evaluate the influence of the residual C15O radioactivity on the accuracy of measured CBF and OEF values with DARG method and also proposed a subtraction technique to minimize the error due to the residual C15O radioactivity. Methods: In the simulation, normal and ischemic conditions were considered. The 15O2 and C 15O2 PET count curves with the residual C15O PET counts were generated by the arterial input function with the residual C15O radioactivity. The amounts of residual C15O radioactivity were varied by changing the interval between the C15O PET scan and 15O2-C15O2 PET scan, and the absolute inhaled radioactivity of the C15O gas. Using the simulated input functions and the PET counts, the CBF and OEF were computed by the DARG method. Furthermore, we evaluated a subtraction method that subtracts the influence of the C15O gas in the input function and PET counts. Results: Our simulations revealed that the CBF and OEF values were underestimated by the residual C15O radioactivity. The magnitude of this underestimation depended on the amount of C15O radioactivity and the physiological conditions. This underestimation was corrected by the subtraction method. Conclusions: This study showed the influence of C 15O radioactivity in DARG protocol, and the magnitude of the influence was affected by several factors, such as the radioactivity of C 15O, and the physiological condition.
- Carbon monoxide
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging