Impact of the lower energy threshold on the NEMA NU2-2001 count-rate performance of a LSO based PET-CT scanner

The aim of this study was to investigate the impact of the lower energy threshold (LET) on the NEMA NU2-2001 count-rate performance of a LSO-based PET scanner (Siemens PET-CT Biograph Sensation 16). The quantitative measurements were focused on three different aspects: noise equivalent count rate (NEC), scatter fraction, and absolute sensitivity.

METHODS

According to the NEMA-NU2-2001 protocol count-rate-performance (NEC-2R, scatter fraction) and sensitivity were evaluated performing serial measurements at LETs of 350, 375, 400, 410, 420, 430, 440, and 450 keV (the upper energy threshold was fixed to 650 keV). NEMA protocols were adapted to account for the intrinsic radioactivity of (176)Lu in the LSO crystals.

RESULTS

Up to a radioactivity concentration of 8 kBq/ml the highest NEC-rates were obtained at an LET of 410 keV, between 8 and 20 kBq/ml at an LET of 420 keV and above 20 kBq/ml at an LET of 430 keV. The overall NEC maximum was 67 kcps at 430 keV (at 28 kBq/ml). The minimum scatter fraction was measured at a radioactivity concentration of approximately 0.5 kBq/ml. The scatter fraction decreased continuously from 45% at an energy threshold of 350 keV to 24% at 450 keV. The maximum sensitivity of 5.8 kcps/MBq, was obtained at an LET of 350 keV and the minimum sensitivity of 4.2 kcps/MBq at an LET of 450 keV. At the LET with the maximum NEC-rate (430 keV) the sensitivity was 4.8 kcps/MBq.

CONCLUSION

The optimal count-rate performance of the LSO-based PET system was found at LETs between 410 keV and 430 keV depending on the actual radioactivity concentration placed in the scanner. A global maximum in NEC count rate was obtained at an LET of 430 keV.

PET imaging problems with the non-standard positron emitters Yttrium-86 and Iodine-124

AIM

Positron emission tomography (PET) imaging of non-standard positron emitters is influenced by gamma-coincidences, i.e. false coincidences produced by the coincident detection of an annihilation photon and a gamma-ray simultaneously emitted with the positron. The extent to which the PET study is disturbed by this effect is dependent on the kind of the positron emitter used, the kind and position of the object, the acquisition mode, i.e. the optional use of septa, and the reconstruction program. In order to demonstrate and study imaging problems with non-standard positron emitters, a phantom was scanned containing non-radioactive rods with different absorption materials and filled with either (124)I or (86)Y in the bidimensional (2D) as well as tridimensional (3D) acquisition mode.

METHODS

For reconstruction, the PET manufacturer's standard software without any modification was used. To reduce errors caused by the gamma-coincidences, a simple linear background subtraction, estimated from the counts at the scanner's external radius, was applied.

RESULTS

Without background subtraction, apparent positive and negative ''radioactivity concentrations'' were found in regions of interest positioned over the non-radioactive rods with values higher for (86)Y compared to (124)I and also higher for 3D compared to 2D. A complete subtraction of the background led to erroneous

RESULTS

The errors in the phantom's non-radioactive rods and the difference between measured and true radioactivity became minimum, when about 75% of the background was subtracted. This refers to both the 2D and 3D mode.

CONCLUSION

Quantitation problems with the non-standard positron emitters (124)I and (86)Y could be minimized in the phantom study examined here by using a simple background subtraction together with the manufacturer's standard correction and reconstruction procedures.

Abnormal postprandial PYY response in insulin sensitive nondiabetic subjects with a strong family history of type 2 diabetes

OBJECTIVE

Gut-derived hormone peptide YY (PYY) is low in subjects with obesity and type 2 diabetes (T2D). However, it is unknown whether this is a primary defect or a consequence of metabolic disturbances. In this study, we aimed to assess whether low fasting and postprandial PYY secretion is an early defect, potentially promoting the development of obesity and T2D, and whether it is modified by macronutrient content.

DESIGN

Prospective cross-sectional cohort study.

SUBJECTS

Nine individuals with a strong family history of T2D (REL) and seven age and adiposity matched individuals with no family history of T2D (CON).

INTERVENTIONS

Metabolic studies including hyperinsulinemic-euglycemic clamp, dual X-ray absorptiometry and two meal tests containing 1000 kcal with an either high fat (76%) or high carbohydrate (76%) content.

MAIN OUTCOME MEASURES

Fasting and postprandial PYY levels were measured and analyzed for potential correlations with markers for adiposity and insulin resistance.

RESULTS

Insulin sensitivity was not different between REL and CON. Fasting glucose, insulin, triglycerides and PYY were also not different between groups. However, the postprandial incremental area under curve (AUC) of PYY was significantly lower in REL after the high carbohydrate (HCHO) meal (+27.3 vs +60.6% increase from baseline, P=0.038). The AUC of insulin during HCHO meal correlated negatively with both AUC and fasting level of PYY (r=-0.58 and -0.60, respectively, P<0.05).

CONCLUSIONS

A blunted postprandial PYY secretion is observed in a very early stage in the development of T2D in genetically susceptible individuals. This defect precedes the presence of insulin resistance and adiposity, and could therefore predispose to the development of T2D.

Acute S-ketamine application does not alter cerebral [18F]altanserin binding: a pilot PET study in humans

Modeling short-term psychotic states with subanaesthetic doses of ketamine provides substantial experimental evidence in support of the glutamate hypothesis of schizophrenia. Ketamine exerts its pharmacological effects both directly via interactions with glutamate receptors and indirectly by stimulating presynaptic release of endogenous serotonin (5-HT). The aim of this feasibility study was to examine whether acute ketamine-induced 5-HT release interferes with the binding of the 5-HT(2A) receptor (5-HT(2A)R) radioligand [(18)F]altanserin and positron emission tomography (PET). Two subjects treated with ketamine and one subject treated with placebo underwent [(18)F]altanserin PET at distribution equilibrium conditions. Robust physiological, psychopathological and cognitive effects were present at ketamine plasma concentrations exceeding 100 microg/l during >70 min. Notwithstanding, we observed stable radioligand binding (changes +/-95% CI of -1.0 +/- 1.6% and +4.1 +/- 1.8% versus -1.2 +/- 2.6%) in large cortical regions presenting high basal uptake of both, [(18)F]altanserin and ketamine. Marginal decreases of 4% of radioligand binding were observed in the frontal lobe, and 8% in a posteriorily specified frontomesial subregion. This finding is not compatible with a specific radioligand displacement from 5-HT(2A)R which should occur proportionally throughout the whole brain. Instead, the spatial pattern of these minor reductions was congruent with ketamine-induced increases in cerebral blood flow observed in a previous study using [(15)O]butanol PET. This may caused by accelerated clearance of unspecifically bound [(18)F]altanserin from cerebral tissue with increased perfusion. In conclusion, this study suggests that [(18)F]altanserin PET is not sensitive to acute neurotransmitter fluctuations under ketamine. Advantageously, the stability of [(18)F]altanserin PET towards acute influences is a prerequisite for its future use to detect sub-acute and chronic effects of ketamine.

Analysis on Spectral Properties of Projection Signals in 3D Tomography

In this paper a new approach is presented to analyze the spectral behavior of the 3D projection signal generated via plane integrals. More accurate determination of the effective support region of the projection spectrum without approximation is realized compared to previous approaches. On the basis of acquired results, a more accurate and optimal interlaced sampling pattern is correspondingly established. Compared to the traditional progressive sampling method, a reduction of sampling points by the factor 4 is achieved.

The control of bone remodeling by neuropeptide Y receptors

An important role for the neuropeptide Y receptor system in the regulation of bone formation was recently revealed with a significant elevation in trabecular bone formation and bone volume following germline or hypothalamus-specific deletion of neuropeptide Y2 receptors in mice. Subsequent studies have now demonstrated that this central pathway is distinct from that of the other centrally regulated bone formation pathway mediated by leptin. This review discusses these recent findings and outlines how these new pathways could translate into potential novel targets for the treatment of bone disease.

Cerebral haemodynamics during hypo- and hypercapnia: determination with simultaneous 15O-butanol-PET and transcranial Doppler sonography

AIM

Transcranial Doppler sonography (TCD) is increasingly used in cerebrovascular disease for monitoring brain perfusion. It allows estimation of cerebral blood flow (CBF) by the measurement of cerebral blood flow velocity (CBFV). The CBFV as well as CBF are intimately associated with the intravascular CO2-concentration. Thus, hyper- or hypocapnia can be used to induce a defined range of blood flows. The aim of our study was the comparison of vasomotor reactivity assessed with simultaneous TCD and quantitative regional CBF-measurements (rCBF) by PET (serving as the reference method for in-vivo quantification of rCBF).

PATIENTS, METHODS

Six healthy young volunteers participated in this study. CBF was measured using 15O-butanol PET. A flow and dispersion-model was fitted to the measured time activity curves using arterial input curves. Each subject underwent five scans at five different end-tidal CO2 levels (EtCO2): 25, 32, 40, 48, and 55 mmHg. CBFV was assessed by continuous bilateral TCD of the middle cerebral artery (MCA). Volumes of interest for rCBF determination were placed in grey matter of the prefrontal cortex (PFC) as determined from individual MRIs. Comparisons between the rCBF, EtCO2 and CBFV were carried out with regression and correlation analysis and paired t-tests.

RESULTS

Strong positive linear correlations of rCBF and CBFV with the CO2-concentration and linear relationships between rCBF and CBFV were found in each individual. Normalised CO2-reactivities measured by TCD and PET were closely correlated.

CONCLUSIONS

TCD-measurements of vascular reactivity in healthy volunteers show a high correlation to those acquired with PET that serves as the reference method of quantitative rCBF-measurement. The results of the MCA insonation are a close approximation of the rCBF changes induced by variations of EtCO2.

Neuropeptide Y regulates recurrent mossy fiber synaptic transmission less effectively in mice than in rats: Correlation with Y2 receptor plasticity

A unique feature of temporal lobe epilepsy is the formation of recurrent excitatory connections among granule cells of the dentate gyrus as a result of mossy fiber sprouting. This novel circuit contributes to a reduced threshold for granule cell synchronization. In the rat, activity of the recurrent mossy fiber pathway is restrained by the neoexpression and spontaneous release of neuropeptide Y (NPY). NPY inhibits glutamate release tonically through activation of presynaptic Y2 receptors. In the present study, the effects of endogenous and applied NPY were investigated in C57Bl/6 mice that had experienced pilocarpine-induced status epilepticus and subsequently developed a robust recurrent mossy fiber pathway. Whole cell patch clamp recordings made from dentate granule cells in hippocampal slices demonstrated that, as in rats, applied NPY inhibits recurrent mossy fiber synaptic transmission, the Y2 receptor antagonist (S)-N2-[[1-[2-[4-[(R,S)-5,11-dihydro-6(6H)-oxodibenz[b,e]azepin-11-yl]-1-piperazinyl]-2-oxoethyl]cyclopentyl]acetyl]-N-[2-[1,2-dihydro-3,5(4H)-dioxo-1,2-diphenyl-3H-1,2,4-triazol-4-yl]ethyl]-argininamide (BIIE0246) blocks its action and BIIE0246 enhances synaptic transmission when applied by itself. Y5 receptor agonists had no significant effect. Thus spontaneous release of NPY tonically inhibits synaptic transmission in mice and its effects are mediated by Y2 receptor activation. However, both NPY and BIIE0246 were much less effective in mice than in rats, despite apparently equivalent expression of NPY in the recurrent mossy fibers. Immunohistochemistry indicated greater expression of Y2 receptors in the mossy fiber pathway of normal mice than of normal rats. Pilocarpine-induced status epilepticus markedly reduced the immunoreactivity of mouse mossy fibers, but increased the immunoreactivity of rat mossy fibers. Mossy fiber growth into the inner portion of the dentate molecular layer was associated with increased Y2 receptor immunoreactivity in rat, but not in mouse. These contrasting receptor changes can explain the quantitatively different effects of endogenously released and applied NPY on recurrent mossy fiber transmission in mice and rats.

Assessment of the short-lived non-pure positron-emitting nuclide (120)I for PET imaging

PURPOSE

The non-pure positron-emitting iodine isotope (120)I (T(1/2)=81 min) is a short-lived alternative to (124)I. (120)I has a positron abundance more than twice that of (124)I and a maximum positron energy of 4 MeV. This study was undertaken to evaluate and characterise the qualitative and quantitative PET imaging of (120)I.

METHODS

(120)I was produced via the (120)Te(p,n) reaction on highly enriched (120)Te. The measurements were done with the Siemens scanner HR+ and the 2D PET scanner GE PC4096+. A cylinder containing three cold inserts and a phantom resembling a human brain slice were used to evaluate half-life, positron abundance and background correction. To analyse the image resolution, a -mm tube placed in water was filled with (120)I and (18)F. Comparisons with (18)F, (124)I and (123)I (measured with SPECT) were made using the Hoffman 3D brain phantom.

RESULTS

The half-life of 81.1 min was reproduced by the PET measurements. The PET-based positron abundance ranged from 47.9% to 55.0%. The reconstructed image resolution found with the HR+ was 5.4 mm FWHM (12.3 mm FWTM), in contrast to 4.6 mm (8.6 mm) when using (18)F. Erroneous positive and negative numbers of radioactivity found in the cold inserts became nearly zero when the background of gamma-coincidences was corrected for. Images of the Hoffman phantom were inferior to those obtained when (18)F or (124)I was applied but superior to the (123)I-SPECT images.

CONCLUSION

Our data show that (120)I of high radionuclidic purity can be regarded as a suitable nuclide for the PET imaging of radioiodine-labelled pharmaceuticals.

Peptide YY ablation in mice leads to the development of hyperinsulinaemia and obesity

AIMS/HYPOTHESIS

Obese people exhibit reduced circulating peptide YY (PYY) levels, but it is unclear whether this is a consequence or cause of obesity. We therefore investigated the effect of Pyy ablation on energy homeostasis.

METHODS

Body composition, i.p. glucose tolerance, food intake and hypothalamic neuropeptide expression were determined in Pyy knock-out and wild-type mice on a normal or high-fat diet.

RESULTS

Pyy knock-out significantly increased bodyweight and increased fat mass by 50% in aged females on a normal diet. Male chow-fed Pyy (-/-) mice were resistant to obesity but became significantly fatter and glucose-intolerant compared with wild-types when fed a high-fat diet. Pyy knock-out animals exhibited significantly elevated fasting or glucose-stimulated serum insulin concentrations vs wild-types, with no increase in basal or fasting-induced food intake. Pyy knock-out decreased or had no effect on neuropeptide Y expression in the arcuate nucleus of the hypothalamus, and significantly increased proopiomelanocortin expression in this region. Male but not female knock-outs exhibited significantly increased growth hormone-releasing hormone expression in the ventromedial hypothalamus and significantly elevated serum IGF-I and testosterone levels. This sex difference in activation of the hypothalamo-pituitary somatotrophic axis by Pyy ablation may contribute to the resistance of chow-fed male knock-outs to late-onset obesity.

CONCLUSIONS/INTERPRETATION

PYY signalling is important in the regulation of energy balance and glucose homeostasis, possibly via regulation of insulin release. Therefore reduced PYY levels may predispose to the development of obesity, particularly with ageing or under conditions of high-fat feeding.