Cerebral [15O] water clearance in humans determined by positron emission tomography: II. Vascular responses to vibrotactile stimulation

Deep-learning-based attenuation correction in dynamic [15O]H2O studies using PET/MRI in healthy volunteers

Quantitative [¹⁵O]H₂O positron emission tomography (PET) is the accepted reference method for regional cerebral blood flow (rCBF) quantification. To perform reliable quantitative [¹⁵O]H₂O-PET studies in PET/MRI scanners, MRI-based attenuation-correction (MRAC) is required. Our aim was to compare two MRAC methods (RESOLUTE and DeepUTE) based on ultrashort echo-time with computed tomography-based reference standard AC (CTAC) in dynamic and static [¹⁵O]H₂O-PET. We compared rCBF from quantitative perfusion maps and activity concentration distribution from static images between AC methods in 25 resting [¹⁵O]H₂O-PET scans from 14 healthy men at whole-brain, regions of interest and voxel-wise levels. Average whole-brain CBF was 39.9 ± 6.0, 39.0 ± 5.8 and 40.0 ± 5.6 ml/100 g/min for CTAC, RESOLUTE and DeepUTE corrected studies respectively. RESOLUTE underestimated whole-brain CBF by 2.1 ± 1.50% and rCBF in all regions of interest (range -2.4%- -1%) compared to CTAC. DeepUTE showed significant rCBF overestimation only in the occipital lobe (0.6 ± 1.1%). Both MRAC methods showed excellent correlation on rCBF and activity concentration with CTAC, with slopes of linear regression lines between 0.97 and 1.01 and R² over 0.99. In conclusion, RESOLUTE and DeepUTE provide AC information comparable to CTAC in dynamic [¹⁵O]H₂O-PET but RESOLUTE is associated with a small but systematic underestimation.

Comparison of simultaneous arterial spin labeling MRI and 15O-H2O PET measurements of regional cerebral blood flow in rest and altered perfusion states

Arterial spin labelling (ASL) is a non-invasive magnetic resonance imaging (MRI) technique that may provide fully quantitative regional cerebral blood flow (rCBF) images. However, before its application in clinical routine, ASL needs to be validated against the clinical gold standard, ¹⁵O-H₂O positron emission tomography (PET). We aimed to compare the two techniques by performing simultaneous quantitative ASL-MRI and ¹⁵O-H₂O-PET examinations in a hybrid PET/MRI scanner. Duplicate rCBF measurements were performed in healthy young subjects (n = 14) in rest, during hyperventilation, and after acetazolamide (post-ACZ), yielding 63 combined PET/MRI datasets in total. Average global CBF by ASL-MRI and ¹⁵O-H₂O-PET was not significantly different in any state (40.0 ± 6.5 and 40.6 ± 4.1 mL/100 g/min, respectively in rest, 24.5 ± 5.1 and 23.4 ± 4.8 mL/100 g/min, respectively, during hyperventilation, and 59.1 ± 10.4 and 64.7 ± 10.0 mL/100 g/min, respectively, post-ACZ). Overall, strong correlation between the two methods was found across all states (slope = 1.01, R²= 0.82), while the correlations within individual states and of reactivity measures were weaker, in particular in rest (R²= 0.05, p = 0.03). Regional distribution was similar, although ASL yielded higher perfusion and absolute reactivity in highly vascularized areas. In conclusion, ASL-MRI and ¹⁵O-H₂O-PET measurements of rCBF are highly correlated across different perfusion states, but with variable correlation within and between hemodynamic states, and systematic differences in regional distribution.

Phase contrast mapping MRI measurements of global cerebral blood flow across different perfusion states - A direct comparison with 15O-H2O positron emission tomography using a hybrid PET/MR system

Phase-contrast mapping (PCM) magnetic resonance imaging (MRI) provides easy-access non-invasive quantification of global cerebral blood flow (gCBF) but its accuracy in altered perfusion states is not established. We aimed to compare paired PCM MRI and 15O-H2O positron emission tomography (PET) measurements of gCBF in different perfusion states in a single scanning session. Duplicate combined gCBF PCM-MRI and 15O-H2O PET measurements were performed in the resting condition, during hyperventilation and after acetazolamide administration (post-ACZ) using a 3T hybrid PET/MR system. A total of 62 paired gCBF measurements were acquired in 14 healthy young male volunteers. Average gCBF in resting state measured by PCM-MRI and 15O-H2O PET were 58.5 ± 10.7 and 38.6 ± 5.7 mL/100 g/min, respectively, during hyperventilation 33 ± 8.6 and 24.7 ± 5.8 mL/100 g/min, respectively, and post-ACZ 89.6 ± 27.1 and 57.3 ± 9.6 mL/100 g/min, respectively. On average, gCBF measured by PCM-MRI was 49% higher compared to 15O-H2O PET. A strong correlation between the two methods across all states was observed (R2 = 0.72, p < 0.001). Bland-Altman analysis suggested a perfusion dependent relative bias resulting in higher relative difference at higher CBF values. In conclusion, measurements of gCBF by PCM-MRI in healthy volunteers show a strong correlation with 15O-H2O PET, but are associated with a large and non-linear perfusion-dependent difference.

Interindividual and regional relationship between cerebral blood flow and glucose metabolism in the resting brain

Studies of the resting brain measurements of cerebral blood flow (CBF) show large interindividual and regional variability, but the metabolic basis of this variability is not fully established. The aim of the present study was to reassess regional and interindividual relationships between cerebral perfusion and glucose metabolism in the resting brain. Regional quantitative measurements of CBF and cerebral metabolic rate of glucose (CMR_glc) were obtained in 24 healthy young men using dynamic [¹⁵O]H₂O and [¹⁸F]fluorodeoxyglucose positron emission tomography (PET). Magnetic resonance imaging measurements of global oxygen extraction fraction (gOEF) and metabolic rate of oxygen ([Formula: see text]) were obtained by combined susceptometry-based sagittal sinus oximetry and phase contrast mapping. No significant interindividual associations between global CBF, global CMR_glc, and [Formula: see text] were observed. Linear mixed-model analysis showed a highly significant association of CBF with CMR_glc regionally. Compared with neocortex significantly higher CBF values than explained by CMR_glc were demonstrated in infratentorial structures, thalami, and mesial temporal cortex, and lower values were found in the striatum and cerebral white matter. The present study shows that absolute quantitative global CBF measurements appear not to be a valid surrogate measure of global cerebral glucose or oxygen consumption, and further demonstrates regionally variable relationship between perfusion and glucose metabolism in the resting brain that could suggest regional differences in energy substrate metabolism. NEW & NOTEWORTHY Using method-independent techniques the study cannot confirm direct interindividual correlations of absolute global values of perfusion with oxygen or glucose metabolism in the resting brain, and absolute global perfusion measurements appear not to be valid surrogate measures of cerebral metabolism. The ratio of both perfusion and oxygen delivery to glucose metabolism varies regionally, also when accounting for known methodological regional bias in quantification of glucose metabolism.

SSFSE sequence functional MRI of the human cervical spinal cord with complex finger tapping

PURPOSE

Functional MR imaging of the human cervical spinal cord was carried out on volunteers during alternated rest and a complex finger tapping task, in order to detect image intensity changes arising from neuronal activity.

METHODS

Functional MR imaging data using single-shot fast spin-echo sequence (SSFSE) with echo time 42.4 ms on a 1.5 T GE Clinical System were acquired in eight subjects performing a complex finger tapping task. Cervical spinal cord activation was measured both in the sagittal and transverse imaging planes. Postprocessing was performed by AFNI (Analysis of Functional Neuroimages) software system.

RESULTS

Intensity changes (5.5-7.6%) were correlated with the time course of stimulation and were consistently detected in both sagittal and transverse imaging planes of the cervical spinal cord. The activated regions localized to the ipsilateral side of the spinal cord in agreement with the neural anatomy.

CONCLUSION

Functional MR imaging signals can be reliably detected with finger tapping activity in the human cervical spinal cord using a SSFSE sequence with 42.4 ms echo time. The anatomic location of neural activity correlates with the muscles used in the finger tapping task.

Tactile-associated fMRI recruitment of the cervical cord in healthy subjects

Using spinal cord functional magnetic resonance imaging (fMRI), 12 right-handed healthy subjects were scanned during a tactile stimulation of the palm of the right hand. The task-related mean signal change was computed for all activated voxels within the cervical cord, and separately, in the four cord quadrants (right and left anterior, right and left posterior) from C5 to C8. The frequency of fMRI activity at each cord level was obtained by assigning a score of 25% at each active quadrant and by averaging the percentage of active quadrants at each level of all subjects. The difference in the occurrence of fMRI activity (a) in right versus left, and anterior versus posterior cord, and (b) among the different cord levels, was evaluated using a random effect logistic regression model, with the frequency of fMRI activity as the dependent variable and the subject as the grouping factor. The task-related mean signal change of all activated voxels of the cord was 3.2% (SD = 0.8%). During the tactile stimulation, subjects showed a higher occurrence of fMRI cord activity in the right than in the left cervical cord (odds ratio = 2.25, 95% confidence interval = 1.31-3.87, P = 0.003). A significant heterogeneity in frequency of fMRI activity between cord levels was also observed (P < 0.001), with the highest frequencies of fMRI activity detected at C6 and C7. Spinal cord fMRI enables to obtain reliable physiological information on the activity of human spinal circuits associated to tactile stimulation. This holds significant promise for a better planning and conduct of studies of people with diseased spinal cords.

Detection of the neuronal activity occurring caudal to the site of spinal cord injury that is elicited during lower limb movement tasks

STUDY DESIGN

Functional magnetic resonance imaging (fMRI) of the spinal cord (spinal fMRI) was used to detect neuronal activity elicited by passive and active lower limb movement tasks, in regions caudal to the injury site in volunteers with spinal cord injury.

OBJECTIVES

The objectives of this project are: (1) to assess the use of spinal fMRI as a tool for detecting neuronal function in the spinal cord below an injury, and (2) to characterize the neuronal response to active and passive movement tasks.

SETTING

Institute for Biodiagnostics, National Research Council of Canada, Winnipeg, Manitoba, Canada.

METHODS

fMRI of the spinal cord was carried out in 12 volunteers with cervical or thoracic spinal cord injuries. Spinal fMRI was carried out in a 1.5 T clinical MR system using established methods. Active and passive lower limb movement tasks were performed, and sagittal images spanning the entire lumbar spinal cord were obtained.

RESULTS

Activity was detected in all volunteers regardless of the extent of injury. During both active and passive participation, activity was seen caudal to the injury site, although the number of active voxels detected with passive movement was less than with the active movement task. Average percent signal change was 13.6% during active participation and 15.0% during passive participation.

CONCLUSIONS

Spinal fMRI is able to detect a neuronal response during both active and passive lower limb movement tasks in the spinal cord caudal to the injury site.

Functional magnetic resonance imaging based on SEEP contrast: response function and anatomical specificity

Functional magnetic resonance imaging based on a non-BOLD-contrast mechanism, which we have termed "SEEP" (Signal Enhancement by Extravascular water Protons), has previously been demonstrated. Here the reproducibility of areas of activity identified with both SEEP and BOLD contrast is assessed in duplicate experiments in healthy volunteers, with relatively high resolution (1.6 mm) image data at 1.5 T. These areas of activity are equally well localized to voxels containing primarily gray matter with the two contrast mechanisms. As in previous studies, areas of SEEP activity are observed to be immediately adjacent to areas of BOLD activity, with very little overlap. The response functions were estimated for both SEEP and BOLD contrast, and are observed to be distinct. The peak SEEP response is observed to lag the BOLD response by approximately 1 s and to decay more slowly with no poststimulus undershoot. Average BOLD signal changes (GE-EPI, TE=50 ms) were observed to be 3.4+/-1.2% (mean+/-S.D.), whereas SEEP signal changes (SE-EPI, TE=23 ms) were 1.9+/-0.5%, consistent with previous studies carried out at 0.2 and 3 T. These observations provide further support for the existence of a non-BOLD-contrast mechanism for fMRI, based on changes in extravascular spin density.

Magnetic resonance imaging of neuronal function in the spinal cord: spinal FMRI

A review of the current literature on magnetic resonance imaging of neuronal function in the spinal cord (spinal fMRI) is presented. The unique challenges of spinal fMRI are identified as being the small cross-sectional dimensions of the spinal cord, magnetic field inhomogeneity caused by the bone and cartilage in the spine, and motion of cerebrospinal fluid, blood, adjacent tissues and organs and of the spinal cord itself. Techniques have been developed to overcome or compensate for these challenges and the result is a fMRI method which is distinct from that used for mapping function in the brain. Evidence that the current spinal fMRI method provides accurate and sensitive maps of neuronal function is also discussed. Studies presented in the literature have demonstrated areas of neuronal activity corresponding with spinal cord neuroanatomy as a result of thermal and electrical stimuli and motor tasks with the hands, arms and legs. Signal intensity changes detected in active areas have also been demonstrated to depend on the intensity of the stimuli with both thermal stimulation and a motor task, providing evidence of the correspondence between spinal fMRI results and neuronal activity in the spinal cord.

Noninvasive assessment of the injured human spinal cord by means of functional magnetic resonance imaging

STUDY DESIGN

A magnetic resonance imaging technique that enables indirect detection of neuronal activity has been developed for the spinal cord. In the present study, this method, spinal functional magnetic resonance imaging (fMRI), is applied to the first study of the injured spinal cord, with the goal of better clinical assessment of the entire cord.

OBJECTIVES

The objectives of this project are: (1) to investigate the neuronal activity that can be detected in the spinal cord caudal to a chronic injury by means of spinal fMRI, and (2) to develop spinal fMRI as a clinical diagnostic tool.

SETTING

Institute for Biodiagnostics, National Research Council of Canada, Winnipeg, Manitoba, Canada.

METHODS

fMRI of the spinal cord was carried out in 27 volunteers with cervical or thoracic spinal cord injuries (SCIs). Of these volunteers, 18 had complete injuries, and nine had incomplete injuries. Spinal fMRI was carried out in a 1.5 T clinical MR system, using established methods. Thermal stimulation at 10 degrees C was applied to the fourth lumbar dermatome on each leg, and images were obtained of the entire lumbar spinal cord.

RESULTS

Areas of neuronal activity were consistently observed in the lumbar spinal cord in response to the thermal stimulation, even when the subjects had no awareness of the sensation. The pattern of activity was notably different compared with noninjured subjects. In general, subjects with complete SCI showed absent or diminished dorsal gray matter activity, but had enhanced ventral activity, particularly contralateral to the stimulation.

CONCLUSIONS

Spinal fMRI is able to provide a noninvasive assessment of the injured spinal cord that does not depend on the patient's perception of the stimulus being applied. This work was carried out on a standard clinical MRI system without modification, and so is readily applicable in most MR units.

SPONSORSHIP

This work was funded by a grant from the Canadian Institutes of Health Research (CIHR).

Functional magnetic resonance imaging at 0.2 Tesla

Functional magnetic resonance imaging of healthy human volunteers was carried out at 0.2 T, using proton-density weighted (TE = 24 ms) spin-echo imaging, in order to eliminate any contribution from the blood oxygenation-level dependent (BOLD) effect. The purpose of the study was to verify the existence of a proton-density change contribution to spin-echo functional magnetic resonance imaging (fMRI) data. Results demonstrated signal intensity changes in motor and sensory areas of the brain during performance of a motor task and cold sensory stimulation of the hand, with signal changes ranging from 1.7 to 2.3%. These values are consistent with 1.9% signal changes observed previously under similar conditions at 3 T. These findings confirm the proton-density change contribution to spin-echo fMRI data and support the theory of signal enhancement by extravascular water protons (SEEP) as a non-BOLD fMRI contrast mechanism. This study also demonstrates that fMRI based on the SEEP contrast mechanism can be carried out at low fields where the BOLD effect is expected to be negligible.

Functional magnetic resonance imaging of the human brain based on signal enhancement by extravascular protons (SEEP fMRI)

Functional magnetic resonance imaging (fMRI) studies of the human brain were carried out at 3 Tesla to investigate an fMRI contrast mechanism that does not arise from the blood oxygen-level dependent (BOLD) effect. This contrast mechanism, signal enhancement by extravascular protons (SEEP), involves only proton-density changes and was recently demonstrated to contribute to fMRI signal changes in the spinal cord. In the present study it is hypothesized that SEEP fMRI can be used to identify areas of neuronal activity in the brain with as much sensitivity and precision as can be achieved with BOLD fMRI. A detailed analysis of the areas of activity, signal intensity time courses, and the contrast-to-noise ratio (CNR), is also presented and compared with the BOLD fMRI results. Experiments were carried out with subjects performing a simple finger-touching task, or observing an alternating checkerboard pattern. Data were acquired using a conventional BOLD fMRI method (gradient-echo (GE) EPI, TE = 30 ms), a conventional method with reduced BOLD sensitivity (GE-EPI, TE = 12 ms), and SEEP fMRI (spin-echo (SE) EPI, TE = 22 ms). The results of this study demonstrate that SEEP fMRI may provide better spatial localization of areas of neuronal activity, and a higher CNR than conventional BOLD fMRI, and has the added benefit of lower sensitivity to field inhomogeneities.

Extravascular proton-density changes as a non-BOLD component of contrast in fMRI of the human spinal cord

The fractional signal intensity change (Delta S/S) observed during activation in T(2)-weighted fMRI of the spinal cord has previously been shown to depend linearly on the echo time (TE) but to have a positive value of roughly 2.5% extrapolated to zero TE. In this study we investigated the origin of this finding by measuring the Delta S/S in spinal fMRI with very short TEs. Our results demonstrate that the Delta S/S does not approach zero, but has a value as high as 3.3% at TE = 11 ms. At TEs > 33 ms we observed the linear relationship between Delta S/S and TE as in previous studies. These data demonstrate that there is a non-BOLD contribution to signal changes observed in spinal fMRI. We hypothesize that this contribution is a local proton density increase due to increased water exudation from capillaries with increased blood flow during neuronal activation, and term this effect "signal enhancement by extravascular protons" (SEEP).

Release of excitatory amino acids in the penumbra of a focal cortical necrosis

A cortical tissue necrosis from focal trauma expands between 30% and 300% from its initial size within 24 h, depending on the species studied. To shed light on the pathophysiological processes in the penumbra 1 zone after a focal cortical lesion, the release of excitatory amino acids into the traumatic penumbra zone 1 was measured throughout the entire period of necrosis expansion. A microdialysis probe was inserted at an oblique angle into the cortex of Sprague-Dawley rats 2 mm below the brain surface. One day later, a highly standardized cortical freezing lesion was induced at the brain cortex above the microdialysis probe. Dialysate was continuously collected prior to, during, and up to 24 h after trauma and analyzed for primary amino acids. In each animal, it was confirmed histologically that the tip of the microdialysis probe was localized in the gray matter in close proximity to the primary lesion. Following induction of the trauma, a statistically significant sharp increase of the dialysate level of aspartate, glutamate, glycine, and serine was observed. Thereafter, the dialysate levels of these amino acids returned to baseline levels without any further increase throughout the remaining observation period. This process ranged in time from a few minutes to a few hours. The level of alanine in the dialysate was essentially not altered throughout the experiment. Although the early post-traumatic increase of the excitatory neurotransmitters aspartate and glutamate may well contribute to the secondary lesion growth of a cortical necrosis after trauma, glutamate receptor targeted therapeutic intervention may be in view of these findings of limited use when initiated post trauma.

Effects of acetazolamide on cerebral blood flow, blood volume, and oxygen metabolism: a positron emission tomography study with healthy volunteers

To evaluate changes in cerebral hemodynamics and metabolism induced by acetazolamide in healthy subjects, positron emission tomography studies for measurement of cerebral perfusion and oxygen consumption were performed. Sixteen healthy volunteers underwent positron emission tomography studies with 15O-gas and water before and after intravenous administration of acetazolamide. Dynamic positron emission tomography data were acquired after bolus injection of H2[15O] and bolus inhalation of 15O2. Cerebral blood flow, metabolic rate of oxygen, and arterial-to-capillary blood volume images were calculated using the three-weighted integral method. The images of cerebral blood volume were calculated using the bolus inhalation technique of C[15O]. The scans for cerebral blood flow and volume and metabolic rate of oxygen after acetazolamide challenge were performed at 10, 20, and 30 minutes after drug injection. The parametric images obtained under the two conditions at baseline and after acetazolamide administration were compared. The global and regional values for cerebral blood flow and volume and arterial-to-capillary blood volume increased significantly after acetazolamide administration compared with the baseline condition, whereas no difference in metabolic rate of oxygen was observed. Acetazolamide-induced increases in both blood flow and volume in the normal brain occurred as a vasodilatory reaction of functioning vessels. The increase in arterial-to-capillary blood volume made the major contribution to the cerebral blood volume increase, indicating that the raise in cerebral blood flow during the acetazolamide challenge is closely related to arterial-to-capillary vasomotor responsiveness.

Role of nitric oxide in the secondary expansion of a cortical brain lesion from cold injury

We have investigated the role of nitric oxide (NO) as mediator of the secondary growth of a traumatic cortical necrosis. For this purpose, a highly standardized focal lesion of the brain was induced in 46 Sprague-Dawley rats by cold injury. Twenty-four hours later--the timepoint of maximal lesion spread--the animals were sacrificed and brains were removed for histomorphometry of the maximal necrosis area and volume. The animals were divided into five experimental groups. Group I received the NO donor L-arginine as i.v. bolus 10 min prior to trauma (300 mg/kg body weight; n = 10) and a second bolus of the same dosage intraperitoneally 1 h after trauma. Group II (n = 10)--serving as control of group I--was infused with an i.v. bolus of 1 mL/kg isotonic saline 10 min prior to and a subsequent bolus i.p. 1 h after trauma. Group III (n = 8) received 100 mg/kg b.w. of the inducible NOS (iNOS) inhibitor aminoguanidine (AG) 1 h before and 8 h after trauma by intraperitoneal route. Group IV was administered with the nitric oxide synthase (NOS) inhibitor N(G)-nitro-L-arginine (L-NNA; 100 mg/kg b.w., i.p.; n = 8); group V--the controls of group III and IV--was administered with isotonic saline (1 mL/kg b.w. i.p.; n = 10) 1 h before and 8 h after trauma. In the control group with i.v./i.p. sham treatment (II), the focal lesion led to a cortical necrosis with a maximum area of 3.1 +/- 0.3 mm2 and a lesion volume of 5.7 +/- 0.5 mm3 at 24 h after trauma. In animals with administration of L-arginine, the focal lesion had a maximum area of 3.1 +/- 0.3 mm2 and a volume of 5.3 +/- 0.5 mm3. Hence, the NO donor did not affect the secondary growth of necrosis. Animals with i.p. sham treatment (group V) had a maximal lesion area of 3.6 +/- 0.2 mm2 and lesion volume of 6.2 +/- 0.4 mm3. Administration of aminoguanidine afforded significant attenuation of the lesion growth. Accordingly, the maximal area of necrosis spread only to 2.8 +/- 0.2 mm2 with a volume of 4.5 +/- 0.5 mm3, respectively, at 24 h after trauma (p < 0.01 vs group V). On the other hand, administration of L-NNA did not influence the maximal lesion area (3.7 +/- 0.2 mm2) or lesion volume (6.5 +/- 0.5 mm3) evolving at 24 h after trauma. Thus, neither the enhancement of the formation of NO by L-arginine nor gross inhibition of the synthesis of NO by L-NNA did affect the secondary spread of the necrosis from a focal trauma. The marked attenuation of the posttraumatic necrosis growth by the iNOS inhibitor aminoguanidine strongly indicates an important role of iNOS product in this phenomenon. These findings, thus, demonstrate that the expansion of a primary necrotic focal lesion is a secondary process which can be therapeutically inhibited. Thereby, the growth of a focal tissue necrosis from trauma is clearly identified as a manifestation of secondary brain damage. This information is deemed important for the better understanding of the pathophysiology of traumatic brain injury and for the targeted development of specific treatment modalities.

Quantitation of regional cerebral blood flow corrected for partial volume effect using O-15 water and PET: I. Theory, error analysis, and stereologic comparison

Limited spatial resolution of positron emission tomography (PET) can cause significant underestimation in the observed regional radioactivity concentration (so-called partial volume effect or PVE) resulting in systematic errors in estimating quantitative physiologic parameters. The authors have formulated four mathematical models that describe the dynamic behavior of a freely diffusible tracer (H215O) in a region of interest (ROI) incorporating estimates of regional tissue flow that are independent of PVE. The current study was intended to evaluate the feasibility of these models and to establish a methodology to accurately quantify regional cerebral blood flow (CBF) corrected for PVE in cortical gray matter regions. Five monkeys were studied with PET after IV H2(15)O two times (n = 3) or three times (n = 2) in a row. Two ROIs were drawn on structural magnetic resonance imaging (MRI) scans and projected onto the PET images in which regional CBF values and the water perfusable tissue fraction for the cortical gray matter tissue (hence the volume of gray matter) were estimated. After the PET study, the animals were killed and stereologic analysis was performed to assess the gray matter mass in the corresponding ROIs. Reproducibility of the estimated parameters and sensitivity to various error sources were also evaluated. All models tested in the current study yielded PVE-corrected regional CBF values (approximately 0.8 mL x min(-1) x g(-1) for models with a term for gray matter tissue and 0.5 mL x min(-1) x g(-1) for models with a term for a mixture of gray matter and white matter tissues). These values were greater than those obtained from ROIs tracing the gray matter cortex using conventional H2(15)O autoradiography (approximately 0.40 mL x min(-1) x g(-1)). Among the four models, configurations that included two parallel tissue compartments demonstrated better results with regards to the agreement of tissue time-activity curve and the Akaike's Information Criteria. Error sensitivity analysis suggested the model that fits three parameters of the gray matter CBF, the gray matter fraction, and the white matter fraction with fixed white matter CBF as the most reliable and suitable for estimating the gray matter CBF. Reproducibility with this model was 11% for estimating the gray matter CBF. The volume of gray matter tissue can also be estimated using this model and was significantly correlated with the results from the stereologic analysis. However, values were significantly smaller compared with those measured by stereologic analysis by 40%, which can not be explained by the methodologic errors. In conclusion, the partial volume correction was essential in quantitation of regional CBF. The method presented in this article provided the PVE-corrected regional CBF in the cortical gray matter tissue. This study also suggests that further studies are required before using MRI derived anatomic information for PVE correction in PET.

Quantitation of regional cerebral blood flow corrected for partial volume effect using O-15 water and PET: II. Normal values and gray matter blood flow response to visual activation

One of the most limiting factors for the accurate quantification of physiologic parameters with positron emission tomography (PET) is the partial volume effect (PVE). To assess the magnitude of this contribution to the measurement of regional cerebral blood flow (rCBF), the authors have formulated four kinetic models each including a parameter defining the perfusable tissue fraction (PTF). The four kinetic models used were 2 one-tissue compartment models with (Model A) and without (Model B) a vascular term and 2 two-tissue compartment models with fixed (Model C) or variable (Model D) white matter flow. Furthermore, rCBF based on the autoradiographic method was measured. The goals of the study were to determine the following in normal humans: (1) the optimal model, (2) the optimal length of fit, (3) the model parameters and their reproducibility, and (4) the effects of data acquisition (2D or 3D). Furthermore, the authors wanted to measure the activation response in the occipital gray matter compartment, and in doing so test the stability of the PTF, during perturbations of rCBF induced by visual stimulation. Eight dynamic PET scans were acquired per subject (n = 8), each for a duration of 6 minutes after IV bolus injection of H2(15)O. Four of these scans were performed using 2D and four using 3D acquisition. Visual stimulation was presented in four scans, and four scans were during rest. Model C was found optimal based on Akaike's Information Criteria (AIC) and had the smallest coefficient of variance after a 6-minute length of fit. Using this model the average PVE corrected rCBF during rest in gray matter was 1.07 mL x min(-1) x g(-1) (0.11 SD), with an average coefficient of variance of 6%. Acquisition mode did not affect the estimated parameters, with the exception of a significant increase in the white matter rCBF using the autoradiographic method (2D: 0.17 mL x min(-1) x g(-1) (0.02 SD); 3D: 0.21 mL x min(-1) x g(-1) (0.02 SD)). At a 6-minute fit the average gray matter CBF using Models C and D were increased by 100% to 150% compared with Models A and B and the autoradiographic method. There were no significant changes in the perfusable tissue fraction by the activation induced rCBF increases. The largest activation response was found using Model C (median = 39.1%). The current study clearly demonstrates the importance of PVE correction in the quantitation of rCBF in normal humans. The potential use of this method is to cost-effectively deliver PVE corrected measures of rCBF and tissue volumes without reference to imaging modalities other than PET.

Brief vibrotactile stimulation does not increase cortical oxygen consumption when measured by single inhalation of positron emitting oxygen

Vibrotactile stimulation of the hand elicits no increase in oxygen consumption commensurate with the increase in blood flow measured in human sensory cortex. To test the hypothesis that previous failures to detect a proportionate increase in oxygen consumption could be an artefact of the sequential bolus, or three-step, method used to measure this parameter in the human brain in vivo, the authors compared the measurements with the results of a novel single bolus, or one-step, method of measuring oxygen consumption. The time of completion of the three-step method was 40 to 50 minutes, whereas the one-step method lasted only 3 minutes. The baseline whole-brain oxygen consumption averaged 185 +/- 32 micromol hg(-1) min(-1) by the three-step method and 153 +/- 15 micromol hg(-1) min(-1) by the one-step method. Vibrotactile stimulation did not elicit a significant increase in oxygen consumption measured by either method. This finding rejects the hypothesis that failure to detect an increase of oxygen consumption could be an artefact caused by limitations of the method used previously. Conversely, it also rejects the hypothesis that observations of an increase of oxygen consumption by the new method are artefacts caused by limitations of the one-step method.

Oxygen consumption of cerebral cortex fails to increase during continued vibrotactile stimulation

The coupling of oxidative metabolism to the blood flow of the sensory motor hand area is uncertain. The authors tested the hypothesis that continued vibrotactile stimulation ultimately must lead to increased oxygen consumption consumption. Twenty-two healthy right-handed young volunteers underwent positron emission tomography (PET) with the [(15)O]water bolus injection method to measure water clearance (K1H2O an index of blood flow (CBF), and with the [(15)O]oxygen bolus inhalation method to measure CMR(O2). The CMR(O2) was measured 30 seconds and 20 minutes after onset of intermittent (1 second on, 1 second off) vibrotactile stimulation (110 Hz) and compared with baseline measurements without stimulation. The K1H2O and CMR(O2) changes (delta K1H2O and delta CMR(O2)) were determined using intersubject averaging, together with magnetic resonance imaging based stereotaxic registration technique. The K1H2O increase was 21 +/- 4% and 12 +/- 4% at 30 seconds and 20 minutes after onset of stimulation, respectively. No significant increase of CMR(O2) was found until 30 minutes after the onset of stimulation. The authors conclude that blood flow and oxidative metabolism undergo uncoupling during sustained phasic stimulation of the sensory hand area. Therefore, neuronal activity stimulated in this manner does not rely on significantly increased oxidative phosphorylation.