Metabolic fate of L-[methyl-11C]methionine in human plasma

The metabolites of L-[methyl-11C]methionine in the plasma of 8 patients with tumors were measured for 60 min after injection. In the plasma, after a rapid clearance, the total radioactivity remained constant, and protein-bound radioactivity increased rapidly. Non protein metabolites detected by HPLC as at least two components besides methionine, increased with time. Significant individual variations for the metabolism were observed. At 60 min after injection, 36.5% (range: 16%-72%) and 45.3% (range: 13%-74%) of the 11C was measured as methionine and labeled proteins, respectively.

[Cerebral glucose metabolism in dementia (PET-FDG study)]

Positron emission tomography (PET) with F-18 fluorodeoxyglucose (FDG) was employed to assess regional cerebral glucose metabolism which is tightly coupled to neuronal activity in the brain. In Alzheimer's and multi-infarct dementia, hypometabolism of glucose was found in frontal, temporal, and parietal association cortices. Focal hypometabolism in association cortices was observed in depression, epilepsy, ALS and other neurological diseases without any symptoms of mental deterioration. These results might indicate that not focal but global decrease of neuronal activity in the association cortex induces demented state.

D2-dopamine receptor specific brain uptake of carbon-11-labeled YM-09151-2

The in vivo D2-receptor specific brain uptake of N-[(2RS,3RS)-1-benzyl-2- methyl-3-pyrrolidinyl]-5-chloro-2-methoxy-4-[11C]methylaminobenzamide ([11C]YM-09151-2), was investigated. In rat brain the high uptake of [11C]YM-09151-2 in striatum was displaced with sulpiride, spiroperidol, and YM-09151-2. SCH-23390 and ritanserin, D1-dopamine and S2-serotonin antagonists, showed no effect on the distribution of [11C]YM-09151-2. In the striatum at 60 min, 95% of the radioactivity was detected as [11C]YM-09151-2 by high performance liquid chromatography. On the other hand, 41% of 11C in the plasma at 60 min was observed as metabolites. In vivo autoradiography showed a high uptake of [11C]YM-09151-2 in the striatum and in the nucleus accumbens of rat brain. A high uptake of radioactivity was also found in the canine basal ganglia with positron emission tomography. The uptake was reduced by pretreatment with spiroperidol. The present results demonstrate that [11C]YM-09151-2 is a D2 receptor specific compound and is a potential in vivo tracer for measuring D2 receptors.

Feasibility study of fluorine-18 labeled dopa for melanoma imaging

Feasibility of fluorine-18 labeled L-dopa for melanoma imaging was investigated. In B16 melanoma-bearing mice given 2-[18F]fluoro-L-dopa, the radioactivity in the B16 decreased for the first 60 min and then remained constant, while all other tissues investigated decreased with time. High tumor uptake ratios for all other tissues except for the pancreas were obtained at 120 min. 6-[18F]Fluoro-L-dopa showed a similar tissue distribution. However, the B16 uptake was about half that value for the 2-fluoro analogue. A higher incorporation rate of 2-[18F]fluoro-L-dopa into the acid-precipitable fraction of the melanoma also showed that the 2-[18F]fluoro-L-dopa was a preferable melanin precursor. Among the four kinds of non-melanoma tumors in mice or rats three tumors showed an uptake of 2-[18F]fluoro-L-dopa similar to the B16 at 60 min. However, larger melanoma-to-tissue uptake ratios were observed when compared to non-melanoma tumors.

[Double tracer whole body autoradiography using a short-lived positron emitter and a long-lived beta emitter]

We investigated glucose and amino acid metabolism in tumors and other organs using whole body autoradiography with a short-lived positron emitter and a long-lived beta emitter. The radioactive compounds used were 2-deoxy-2-[18F]-fluoro-D-glucose (18F-FDG) with a half life of 109.8 min and L-[methyl-14C]-methionine (14C-MET) with a half life of 5,730 years. A Donryu rat weighing about 150 g was subcutaneously inoculated at the back with experimental tumors of AH109A and AH272. 74 MBq (2 mCi) of 18F-FDG and 740 kBq (20 microCi) of 14C-MET was administered and after 30 min, the rat was sacrificed. Whole body frozen sections were obtained using autocryotome. For the 18F-FDG autoradiogram, the frozen sections were exposed to an X-ray film for 6 h. After seven days, these frozen sections were again exposed to 14C-MET for a week. Cross-contamination was minimized by adjusting the exposure time, the interval of exposures and the administered dose. The accumulation of the tracers was represented as the optical density ratio of the tissue of interest to the muscle. The tumor ratios were 12.5 for 18F-FDG and 8.6 for 14C-MET showing the highest accumulation in the whole body autoradiogram. In contrast the inflammatory tissue ratios were 1.27 for 18F-FDG and 0.77 for 14C-MET showing very low amino acid metabolism. With the present double tracer whole body autoradiogram, 18F-FDG accumulation was seen in the brain and the heart but not to the liver as against 14C-MET accumulation which was seen to the liver but not to the brain and the heart.

Relationship between histologic type of primary lung cancer and carbon-11-L-methionine uptake with positron emission tomography

L-[Methyl-11C]-methionine [( 11C]methionine) has proved to be one of the useful amino acids for the diagnosis of human cancer. We examined whether there was any correlation between [11C]methionine uptake and histologic type of primary lung cancer. Sixteen patients with nine squamous cell carcinoma, five large cell carcinoma, one small cell carcinoma, and one adenocarcinoma were studied using positron emission tomography (PET). All patients had high accumulation of [11C]methionine in lung tumors. We evaluated [11C]methionine uptake into the tumor by a semiquantitative value, DUR (Differential Uptake Ratio). There was significant difference (p less than 0.01, Mann-Whitney test) of [11C]methionine uptake between large cell carcinoma (3.98 +/- 0.27) and squamous cell carcinoma (2.92 +/- 0.30). The result suggested that there was correlation between [11C]methionine accumulation and the histologic type of lung cancer. This indicates a new potential applicability of [11C]methionine PET for the study of lung cancer.

Differential diagnosis of solitary pulmonary nodules with positron emission tomography using [11C]L-methionine

Two patients with solitary pulmonary nodules, 1.5-2.0 cm in diameter, were studied by positron emission tomography using [11C-Methyl]L-methionine (11C-Met). Case 1 showed high accumulation of 11C-Met in the tumor, and a tumor/muscle ratio of 6.0 suggesting malignancy. Tissue obtained by biopsy revealed a squamous cell carcinoma. Case 2 showed nonspecific isotope accumulation in the tumor, and a tumor/muscle ratio of 1.2 suggesting a benign lesion. Lung biopsy demonstrated granuloma. Positron emission tomography with 11C-Met seems to be useful for the differential diagnosis of solitary lung nodules.

Cortical motor-sensory hypometabolism in amyotrophic lateral sclerosis: a PET study

We previously reported generalized cerebral glucose hypometabolism in amyotrophic lateral sclerosis (ALS) patients with upper motor neuron disease, using positron emission tomography (PET) with [18F]2-fluoro-2-deoxy-D-glucose. The present article presents a more detailed regional analysis of the hypometabolism, including measurements of the motor-sensory cortex at higher levels than used earlier. The analysis is based on 19 PET studies of 12 patients with ALS, four of whom had only lower motor neuron involvement, and 11 studies of age-matched control subjects. A brain size correction was included to eliminate differences in metabolism related to brain size but not to pathology. The eight ALS patients with both upper and lower motor neuron disease showed generalized hypometabolism, compared with the normal control subjects, that was greatest in the motor-sensory cortex and putamen. The motor-sensory deficit was strongly correlated with length of disease, and a marked sequential reduction was seen in repeat studies on four of the patients. There was also significant right-left asymmetry in these scans. No cerebral hypometabolism was seen in the four ALS patients without upper motor neuron involvement. Although the observed motor-sensory deficit in ALS is consistent with histopathological findings, the more generalized hypometabolism and the asymmetry suggest more widespread effects.

Positron CT imaging of an impending stroke

We present PET findings of a case of a transient ischemic attack which later progressed to cerebral infarction. Cerebral blood flow at the stroke focus in the right parietal cortex measured after a TIA attack and before stroke was as low as 24 ml/100 g/min with some increase in oxygen extraction fraction and blood volume. The condition was compatible with "misery perfusion". This case may be an example suggestive that the "misery perfusion sign" is a warning of impending stroke and its poor prognosis if left without appropriate treatments.

Measurement of the ratio of cerebral oxygen consumption to glucose utilization by positron emission tomography: its consistency with the values determined by the Kety-Schmidt method in normal volunteers

The regional interrelationship between cerebral oxygen consumption (CMRO2) and cerebral glucose utilization (CMRGlc) was studied in normal subjects using positron emission tomography (PET) and the 15O steady-state inhalation and the [18F]fluoro deoxyglucose method. The use of standard sets of rate constants and the model lumped constant of 0.52 as well as the regional blood-brain partition coefficient for water and the blood volume correction for oxygen extraction fraction provided a CMRO2/CMRGlc ratio of 4.89 in the cortical gray matter, 5.27 in the basal ganglia and 5.82 in the centrum semiovale (white matter). The values of CMRO2/CMRGlc for the basal ganglia and the white matter were consistent with those reported for the whole brain with the Kety-Schmidt method. There was no significant difference in the CMRO2/CMRGlc between the basal ganglia and the white matter indicating the similar nature of in vivo oxidative metabolism of glucose in neuron-rich region and glial cell-rich region.

Lowered cerebral glucose utilization in amyotrophic lateral sclerosis

Regional cerebral metabolic rates for glucose (rCMRGlc) were analyzed in 19 studies of 12 patients with amyotrophic lateral sclerosis (ALS) by positron emission tomography (PET) with [18F]2-fluoro-2-deoxy-D-glucose. In the 8 ALS patients with upper motor neuron signs, the mean cortical rCMRGlc was significantly lower than in 11 age-matched control subjects (p less than 0.01). The degree of hypometabolism correlated with the duration of the clinical signs and extended throughout the cortex and basal ganglia, but not to the cerebellum. Of the 4 such patients who had repeat PET scans, 3 demonstrated significant subsequent reduction in the rCMRGlc, corresponding to the worsening of the clinical picture. In contrast, 4 ALS patients with disease confined to lower motor neurons and 3 patients with lower motor neuron disease from old paralytic poliomyelitis had normal or near-normal rCMRGlc throughout the brain. Because histological evidence shows no generalized neuronal cell loss in the cortex of ALS patients, including in some cases the primary motor regions, the demonstration of severe generalized hypometabolism in structurally normal cortex indicates that some cortical neurons exist in a state of neuronal nonfunction, rather than cell death, and that anatomoclinical correlations may be more complex. The data also indicate that ALS with upper motor neuron involvement extends beyond the corticospinal tracts and differs in cortical function from the ALS confined to lower motor neurons or the other lower motor neuron disorders.

Haemodynamics and oxygen metabolism in patients after reversible ischaemic attack or minor ischaemic stroke assessed with positron emission tomography

Regional cerebral blood flow (CBF), blood volume (CBV) and oxygen metabolic rate (CMRO2) were evaluated and compared among normals, patients with recent reversible ischaemic attacks (RIAs) and patients with chronic minor infarction using positron emission tomography. Average CBF together with CMRO2 significantly decreased in the infarction group in the middle cerebral artery territory of the affected hemisphere while the mean values for RIAs were intermediate between the other two groups. CBV also reduced, however it was more preserved compared to flow as seen in decreased CBF/CBV values. Significant interhemispheric difference was found in CBF/CBV ratio, but it did not clearly correlate with OEF changes. Higher OEF was noted only in the restricted brain regions of RIAs where CBF showed large hemispheric asymmetry. However, in other regions, the coupled decline of blood flow and metabolism was found which suggests tissue damage or neuronal cell loss in the brain with previous RIA symptoms.

Human cerebral glucose metabolism determined by positron emission tomography: a revisit

The cerebral glucose utilization rate was studied for 27 normal volunteers with 18F-deoxyglucose positron emission tomography (PET). The scanner has a spatial resolution of 6-7 mm and contains corrections for scatter, attenuation, and random coincidences. The lumped constant (tracer-to-glucose dynamic uptake ratio) was determined by comparing the average global uptake of tracer in representative slices with average glucose utilization rates measured by the Kety-Schmidt method as reported in the literature. The resulting value of 0.50 is in excellent agreement with a recent direct determination done by arterial and jugular bulb blood sampling. Gray and white matter values of glucose utilization in various areas of the brain were determined by placing small regions of interest over various cortical, basal, and white matter structures. These values are within 20% of published autoradiographic data on the macaque monkey. The average ratio of gray to white glucose utilization was 2.9, compared with a range of 3-5 for the monkey study and 1.6-2.2 reported in previous PET studies. The effect of instrumental errors on the results is analyzed and discussed.

Glucose utilization by intracranial meningiomas as an index of tumor aggressivity and probability of recurrence: a PET study

Seventeen patients with intracranial meningiomas were studied with positron emission tomography and fluorine-18-2-fluorodeoxyglucose (PET-FDG) to assess the glucose utilization of these tumors. Four meningiomas followed for 3-5 years after PET-FDG and surgery showed no evidence of recurrence. These tumors had significantly lower glucose utilization rates (1.9 mg/dl/min +/- 1.0) than 11 recurrent or regrowing meningiomas (4.5 mg/dl/min +/- 1.96) (P less than .01). The glucose metabolic rates of meningiomas correlated with tumor growth, as estimated from changes in tumor size on repeated computed tomographic scans. Histopathologically, a syncytial (atypical) meningioma had the highest glucose utilization rate, followed by a papillary meningioma and an angioblastic meningioma. Individual transitional and syncytial (typical) meningiomas showed marked differences in glucose metabolism despite similar microscopic appearance. Glucose utilization rate appears to be at least as reliable as histologic classification and other proposed criteria for predicting the behavior and recurrence of intracranial meningiomas.

Global cerebral glucose utilization is independent of brain size: a PET Study

Cerebral glucose metabolic rates were measured in 80 normal volunteers by studying the uptake of [18F]deoxyglucose with positron emission tomography (PET), using three PET scanners. A brain size index was determined from the PET images using either length-width or area measurements of the brain at a standard level. There was a significant negative correlation between glucose metabolism per unit volume and brain size that was well described by an inverse functional relationship, implying that the total glucose consumption of the brain is approximately constant. Analyses of men versus women revealed no sex differences in total brain glucose consumption, although there were differences in brain size and in glucose metabolism per unit volume. Similarly there was no significant correlation of total brain glucose consumption with age. The variation with brain size accounted for 46% of the logarithmic intersubject metabolic variance. When comparing global metabolic rates in different subjects, multiplying the rates by a brain size index has the dual advantage of correcting for differences related to brain size and correcting for differences in cerebrospinal fluid volume.

Glucose utilization rate versus brain size in humans

Cerebral glucose metabolic rates were measured in 23 normal volunteers by studying the uptake of 18F-deoxyglucose with positron emission tomography (PET). These values were correlated against a brain-size index obtained from the PET images by measuring the lateral and anteroposterior brain diameters. There was a significant negative correlation (p less than 0.001), which corresponds, within the statistical uncertainty, to an inverse proportionality of glucose metabolic rate and brain volume. The variation with brain size accounted for approximately one-half of the total intersubject variance. Measurements on phantoms of different sizes and analyses of instrumental errors failed to uncover any artifactual reason for the correlation.

In vivo kinetics and displacement study of a carbon-11-labeled hallucinogen, N,N-[11C]dimethyltryptamine

The endogenous hallucinogen, N,N-dimethyltryptamine (DMT), was labeled with carbon-11 and its regional distribution in rat brain studied. [11C]DMT showed higher accumulation in the cerebral cortex, caudate putamen, and amygdaloid nuclei. Studies of the subcellular distribution of [11C]DMT revealed the specific localization in the fractions enriched with serotonin receptors only when a very low dose was injected into rats. The proportions of the radioactivity in receptor-rich fractions were greatly enhanced by pretreatment with the monoamine oxidase inhibitor, pargyline. Specific binding of [11C]DMT to serotonin receptors in dog brain was demonstrated by a positron emission tomographic study in which 5-methoxy-N,N-dimethyltryptamine caused approximately 20% displacement of the radioligand from the receptors.

Metabolic imaging in hemianopsia using positron emission tomography with 18F-deoxyfluoroglucose

To evaluate the usefulness of metabolic mapping by positron emission tomography using 18F-deoxyfluoroglucose as a tracer in the diagnosis of hemianopsia, we examined eight patients who had had cerebrovascular accident, and four controls. Neuro-ophthalmologic examination disclosed hemianopsia in five and incomplete hemianopsia in three patients; computed tomography showed low-density areas in four patients; and nuclear magnetic resonance imaging demonstrated a prolonged T2 area in five patients. The cerebral metabolic rate for glucose without visual stimulation in the visual cortex was 7.4 +/- 1.0 mg/min/100 g of brain without interhemispheric asymmetry. Light stimulation increased cerebral metabolic rate for glucose in the visual cortex of the nonaffected hemisphere and decreased it in the affected hemisphere. Asymmetry in the metabolic rate in the posterior medial occipital cortex in complete hemianopsia was 22% 12% (P less than .01).

Characteristics of specific in vivo labeling of neuroleptic binding sites with 3-N-[11C]methylspiperone

In vivo binding of 3-N-[11C]methylspiperone ([11C]NMSP) was saturable in the rat forebrain, but not in the cerebellum. Nonspecific binding was almost equivalent in all brain regions except for the white matter. [11C]NMSP binding was localized to receptor-rich fractions when low doses were administered (less than 20 nmol/kg body weight). The striatum-to-cerebellum ratio was a function of time after injection and administered dose. This ratio remained constant in low doses of under 30 nmol/kg. The radioactivity curve of the cerebellum in a control positron-emission tomographic study almost equaled that of the striatum in the dog pretreated with spiperone (2 mg). This indicates that the amount of binding in the cerebellum might be considered a nonspecific binding and unbound pool. The data obtained by the pretreatment study was different from that of displacement, which suggested that displaceable [11C]NMSP in the specific binding sites of the striatum was not completely cleared from the brain tissue by a large amount of unlabeled spiperone.