Experimental studies on myocardial glucose metabolism of rats with 18F-2-fluoro-2-deoxy-D-glucose

The myocardial uptake of 18F-FDG was investigated under various conditions, and compared with brain and tumor uptake as a function of blood glucose level. The uptake by the heart of normal feeding rats was rapid and remained essentially unchanged up to 2 h after 18F-FDG injection, approximately 3%-4% dose/g tissue. On the other hand, the myocardial uptake of fasted rats was significantly lower than that of control rats throughout the course of the study, and it was about 0.3%-0.4% dose/g tissue. Myocardial uptake of 18F-FDG was relatively constant at glucose levels under about 120 mg/100 ml and increased steeply at higher blood glucose levels. In contrast, brain uptake decreased linearly with increasing levels of blood glucose, revealing a strong negative correlation between brain uptake of 18F-FDG and blood glucose levels. The tumor uptake pattern remained relatively unchanged, irrespective of blood glucose levels. It was revealed that the glucose demands of brain, heart, and tumor were entirely different. After a glucose load, the myocardial uptake of fasted rats increased only slightly from 0.4% to 0.6% dose/g tissue, in spite of transitional hyperglycemia. In contrast, insulin caused myocardial uptake to increase extraordinarily, although it caused a decrease in blood glucose levels.

Lung tumor imaging by positron emission tomography using C-11 L-methionine

This paper described the first clinical study of lung tumor scanning by positron emission tomography (PET) using C-11-labeled L-methionine (11C-L-Met). Tumor images were clearly visualized by high contrast in eight lung cancer patients and also in a patient with a silicotic nodule. Quantitative evaluations of methionine uptake in tumor tissue and normal tissue by comparing differential uptake ratios suggested that the extent to which 11C-L-Met accumulates in a tumor is closely correlated to the tumor's viability such as benign or malignant, viable or necrotic. 11C-L-Met is considered to be an effective tumor marker for PET diagnosis which represents increased amino acid metabolism of tumors in the mediastinum and lung.

Association of hypertension with increased atrophy of brain matter in the elderly

Atrophy of brain matter in hypertensive and normotensive subjects was studied by quantitative measurements of brain volume and cranial cavity volume using x-ray computed tomography. The 123 normotensive subjects ranged in age from 20 to 79 years and were divided into six ten-year age groups. The 67 hypertensive subjects ranged in age from 40 to 83 years and were divided into four age groups. Values of the brain volume index ( BVI ), the ratio of brain matter volume to cranial cavity volume, for hypertensives and normotensives in the same age groups were compared. Mean BVI values were significantly lower in hypertensives in the fifth (P less than 0.01), sixth (P less than 0.01), seventh (P less than 0.05) and eighth and ninth decades of life (P less than 0.001). Systemic hypertension, which may induce various diseases in the elderly, had a striking effect on atrophic changes of brain matter in elderly subjects.

[Whole body autoradiography by positron emitting radionuclides]

The technique of freezing whole body autoradiography using positron emitting nuclides has been developed in the present study. Because of rapid decay of positron emitters, a frozen section to contact with a X-ray film must be prepared within a few hours. All the procedures to obtain autoradiograms of rats using 18F-2-deoxy-2-fluoro-D-glucose (18F-FDG) or 11C-glucose-fructose mixture (11C-glucose) were described in detail. In the present technique, exposure must be performed at -20 degrees C to keep a section frozen. Density of X-ray films after exposure at 20 degrees C or -20 degrees C was examined using various radioactive sections. The reduction of the density exposed at -20 degrees C was observed. But the density exposed at -20 degrees C was proportional to the radioactivity. Freezing whole body autoradiography of rats bearing subcutaneous AH109A tumors was performed using 18F-FDG (half life of 109.7 min) and 11C-glucose (half life of 20 min). Density of tumors and other organs on the autoradiogram was comparable with tissue distribution studies of 18F-FDG and 11C-glucose. Freezing whole body autoradiography can be feasible for the analysis of tissue distribution on positron emitting radiopharmaceuticals.

Disturbance of oxidative metabolism of glucose in recent human cerebral infarcts

Eight patients with recent cerebral hemispheric infarction were studied with positron emission tomography and the oxygen-15 steady-state inhalation and [18F]deoxyglucose techniques to obtain values of regional cerebral blood flow, oxygen consumption, and glucose metabolism. The Sokoloff equation, used to calculate glucose metabolism, was simplified to exclude the exponential terms containing the rate constants. A value of the lumped constant quoted for normal brain (0.42) was used for infarcted regions and contralateral hemisphere. Mean regional cerebral blood flow, oxygen consumption, and glucose metabolism were all significantly depressed within the infarcts compared with the mirror regions in the contralateral cerebral hemisphere. The mean fractional extraction of oxygen was low, indicating an adequate supply of oxygen for residual oxidative metabolism. Regional oxygen consumption and glucose metabolism were significantly correlated within the infarcts, but with a relationship of 2 moles of oxygen per mole of glucose--one-third that in the contralateral hemisphere and in normal brain. Although these results suggest that the metabolizing tissue of a recent cerebral infarct utilizes aerobic glycolysis, caution about the validity of this pathophysiological observation is dictated by limitations in current positron emission tomographic tracer methodology.

In vivo disturbance of the oxidative metabolism of glucose in human cerebral gliomas

Abnormalities in the oxidative metabolism of glucose in human cerebral gliomas have been studied in seven patients using positron emission tomography. Measurements of regional cerebral blood flow and oxygen consumption were obtained using the oxygen-15 steady-state inhalation technique. Values of regional cerebral glucose consumption were obtained using fluorine 18-labeled 2-fluoro-2-deoxy-D-glucose and a simplification of the method of Sokoloff. Functional values were obtained for regions of tumor and brain tissue in the middle cerebral artery territory of the contralateral cortex. Values of regional glucose consumption were calculated for both regions using a value of the lumped constant quoted for normal brain tissue (0.42). Tumor regional cerebral blood flow was comparable to that in the contralateral cortex, whereas regional cerebral oxygen consumption was depressed. This depression resulted in low tumor values of the fractional oxygen extraction ratio (0.21 +/- 0.07), indicating that oxygen supply exceeded the metabolic demand. In contrast, tumor regional cerebral glucose consumption was not depressed and regional glucose extraction ratios were similar for tumor and brain tissue. The metabolic uncoupling between regional oxygen consumption and regional glucose consumption (CMRO2/CMRGlu = 0.24 +/- 0.07 ml of oxygen per milligram of glucose) is indicative of increased aerobic glycolysis.

Effects of smoking on regional cerebral blood flow in neurologically normal subjects

The chronic effects of smoking on regional cerebral blood flow (CBF), and on serum lipids and lipoprotein levels in neurologically normal subjects, were studied. CBF was studied by the 133-Xenon inhalation method and gray matter flow was calculated following the method of Obrist et al. One hundred and eleven subjects, who had no abnormalities in neurological examinations nor in CT scans, were divided into two groups: smokers (37) and non-smokers (74). Those who had a smoking index (Number of cigarettes/day) X (years of smoking history) greater than 200 were designated as smokers. The mean smoking index of smokers was 760. Sixty-two of the 74 subjects in the non-smoking group had never smoked, and the mean smoking index of non-smokers was 17. In the male, CBF was significantly lower in smokers than in non-smokers (mean CBF, 12.5% lower in smokers, p less than 0.001). Increased reduction of CBF with advancing age was also observed. Compared to non-smokers, CBF in smokers was found to be significantly lower than the expected age matched value. Serum high density lipoprotein cholesterol values in smokers were significantly lower, and total cholesterol levels significantly higher than in non-smokers. We concluded that smoking chronically reduces CBF. Decrease of CBF in smokers was probably due to advanced atherosclerosis which produces vascular narrowing and raised resistance in cerebral blood vessels.

Correlations between regional cerebral blood flow and age-related brain atrophy: a quantitative study with computed tomography and the xenon-133 inhalation method

One hundred and two subjects (40 men and 62 women) neither having a history of neurologic deficits nor showing organic lesions on computed tomographic examination of the brain were studied. Ages of the subjects ranged from 26 to 81 years. Regional cerebral blood flow was measured by the xenon-133 inhalation method, and the volume percentage of brain with respect to the cranial cavity (craniocerebral index) was calculated by means of computer programs. Regional cerebral blood flow was computed as the fast component of two-compartmental analysis and as the initial slope index value. The percentage of each subject's craniocerebral index in relation to the standard for subjects with non-atrophied brains (brain volume index) was calculated as the indicator of brain atrophy. Both the mean brain fast component values and the mean brain initial slope index values correlated closely with the brain volume index in the elderly (r = 0.60, r = 0.62; P less than 0.0001 in each correlation coefficient). Low cerebral blood flow values coincided with loss of brain substance in the final stage of age-related brain atrophy, but not in the intermediate stage.

Age-related changes of the cranial bone mineral: a quantitative study with computed tomography

Age-related changes of the cranial bone mineral in 495 subjects were assessed by computed tomography (CT) in terms of the Hounsfield number. By means of computer programs available in the CT system, the histograms for the bone were obtained. The peak of this histogram for males increased gradually and reached a plateau beyond 20 years of age, while that for females rose rather steeply from age 0 to age 20 and formed a plateau in the 20s and 30s, then declined precipitously from a value of 1164 +/- 143 to a value of 629 +/- 119 in the 70s and older. In the 20s and 30s, the peak for females was greater than that for males. The total pixel number of this histogram was constant after the 20s. The pixel number of the peak for males made a plateau after the 10s, but that for females showed a similar pattern until the 40s, then increased steeply after the 50s. The peak may reflect calcium concentration of the cranial bone, and therefore the skull of the female may store more calcium than that of the male in the 20s and 30s.

Experimental study for cancer diagnosis with positron-labeled fluorinated glucose analogs: [18F]-2-fluoro-2-deoxy-D-mannose: a new tracer for cancer detection

18F-2-fluoro-2-deoxy-D-glucose (18F-FDG) and 18F-2-fluoro-2-deoxy-D-mannose (18F-FDM) were tested as tumor diagnostic agents in a transplantable rat tumor and rabbit tumors. Tissue distribution studies in rats showed high tumor uptakes of both radiopharmaceuticals. The tumor uptake reached 2.65 +/- 0.61% dose 18 dose F-FDG/g and 2.65 +/- 0.81% dose 18F-FDM/g at 60 min and remained relatively constant until 120 min. Blood clearance both 18F-FDG and 18F-FDM was very rapid and tumor-to-blood ratios reached 22.1 and 29.4 at 60 min, respectively. Tumor-to-tissue ratios of both radiopharmaceuticals were very high in most organs, especially in the liver, kidney, and pancreas. Positron emission tomography (PET) of rabbit tumor with 18F-FDM clearly delineated the main tumor, central necrosis, and lymph node metastases. These data suggested that 18F-FDM, which is a by-product of 18F-FDG synthesis was also an excellent cancer diagnostic agent as well as 18F-FDG. This is not only a new feature of 18F-FDM, but also an economical improvement on cancer diagnosis by PET.

Sex difference in brain atrophy during aging; a quantitative study with computed tomography

Brain atrophy in 154 men and 147 women without neurologic deficits was quantitatively studied by means of computed tomography. The ages ranged from 20 to 79 years. The volume percentage of brain to cranial cavity (Craniocerebral Index, or CCI) was calculated by means of computer programs available in CT systems. The mean CCI in the 20-39 age group was constant at 98.4 per cent in men and 98.7 in women, and this was considered the standard for the CCI in subjects with nonatrophied brains. The percentage of each subject's CCI in relation to this standard in both sexes (Brain Volume Index, or BVI) was calculated as the indicator of brain atrophy. The normal value for BVI was therefore 100 per cent in both sexes. A clear difference was observed between men and women in the process of brain atrophy with increasing age. In men a significant reduction in BVI began in the sixth decade of life (P less than 0.01); thereafter, the decline was gradual and steady through the eighth decade (P less than 0.05). In women, a significant reduction in BVI began in the fifth decade (P less than 0.01) and remained relatively constant during the fifth and sixth decades but declined significantly again in the seventh and eighth decades. In both sexes, remarkable individual differences in brain atrophy were characteristic.

Age-related brain atrophy and mental deterioration--a study with computed tomography

The relation of brain atrophy measured with computed tomography (CT) to mental deterioration on living people was studied. A newly improved technique for quantitative measurement of brain atrophy was developed. The pixels inside the head slices were divided into three parts; brain skull, and cerebrospinal fluid according to their CT number. The volume of brain, CSF, and cranial cavity were calculated by counting the number of pixels of each tissue. Results from 130 normal brains showed that the CSF volume was constant at about 16 ml through 20--39 years old. After 40 years the mean CSF volume increased drastically and reached 71 ml in the seventies. The volume of the brain was standardized for comparison between different-sized heads (brain volume index: BVI). The mean BVI decreased with statistical significance after 40 years of age. Mental function of these persons were evaluated using Hasegawa's dementia rating scale for the elderly. Progression of brain atrophy accompanied loss of mental activities (p less than 0.01).