Measurement of human cerebral blood flow with [15O]butanol and positron emission tomography

Total-Body Perfusion Imaging with [11C]-Butanol

Tissue perfusion can be affected by physiology or disease. With the advent of total-body PET, quantitative measurement of perfusion across the entire body is possible. [11C]-butanol is a perfusion tracer with a superior extraction fraction compared with [15O]-water and [13N]-ammonia. To develop the methodology for total-body perfusion imaging, a pilot study using [11C]-butanol on the uEXPLORER total-body PET/CT scanner was conducted. Methods: Eight participants (6 healthy volunteers and 2 patients with peripheral vascular disease [PVD]) were injected with a bolus of [11C]-butanol and underwent 30-min dynamic acquisitions. Three healthy volunteers underwent repeat studies at rest (baseline) to assess test-retest reproducibility; 1 volunteer underwent paired rest and cold pressor test (CPT) studies. Changes in perfusion were measured in the paired rest-CPT study. For PVD patients, local changes in perfusion were investigated and correlated with patient medical history. Regional and parametric kinetic analysis methods were developed using a 1-tissue compartment model and leading-edge delay correction. Results: Estimated baseline perfusion values ranged from 0.02 to 1.95 mL·min-1·cm-3 across organs. Test-retest analysis showed that repeat baseline perfusion measurements were highly correlated (slope, 0.99; Pearson r = 0.96, P < 0.001). For the CPT subject, the largest regional increases were in skeletal muscle (psoas, 142%) and the myocardium (64%). One of the PVD patients showed increased collateral vessel growth in the calf because of a peripheral stenosis. Comorbidities including myocardial infarction, hypothyroidism, and renal failure were correlated with variations in organ-specific perfusion. Conclusion: This pilot study demonstrates the ability to obtain reproducible measurements of total-body perfusion using [11C]-butanol. The methods are sensitive to local perturbations in flow because of physiologic stressors and disease.

A scoping review of the discrepancies in the measurement of cerebral blood flow in idiopathic intracranial hypertension: oligemia, euvolemia or hyperemia?

BACKGROUND

The literature regarding the global cerebral blood flow (CBF) in idiopathic intracranial hypertension (IIH) is divergent leading to skepticism about the significance of blood flow to the disease's underlying pathophysiology.

METHODS

The purpose of the current paper is to perform a PRISMA scoping review of the literature describing the CBF in IIH. The review investigated the PUBMED and Scopus data bases looking at case mix, technique and the methodologies employed by the studies selected.

DISCUSSION

Many studies indicate that the flow in IIH is normal but others show the flow to be altered. These later studies show a range of flows from a reduction of 20% to an increase of 50% compared to control values. Obesity is a common finding in IIH and is known to reduce CBF, anemia occurs in approximately 20% of IIH patients and is a potent cause of an increased CBF. Thus, variations in case mix may have a significant effect on the final outcome in those studies which are underpowered. The varying techniques which have been used to estimate CBF have differing strengths and weaknesses which may also have a bearing on the outcome. Some papers have significant confounding methodological issues.

CONCLUSIONS

This review suggests each of the variables investigated are responsible for the divergent CBF findings in IIH.

Non-contrast estimate of blood-brain barrier permeability in humans using arterial spin labeling and magnetization transfer at 7 T

Blood-brain barrier (BBB) dysfunction is associated with a number of central nervous system diseases. This study demonstrates the application of a novel noninvasive technique to measure the BBB permeability in the human brain at 7 T. The technique exploits the fact that, when tissue macromolecules are saturated by off-resonance RF pulse, the intravascular and the extravascular (tissue) water experience different magnetization transfer effects. This principle was combined with arterial spin labeling to distinguish between the intravascular and the tissue water, and was used to calculate perfusion, water extraction fraction (E), and BBB permeability surface area product for water (PS). Simultaneous coregistered magnetization transfer ratio maps were also generated that can provide valuable additional information. Eighteen healthy volunteers (seven females), age = 27 ± 11 years and weight = 65 ± 9 kg, participated in the study. Average perfusion was 67 ± 5 and 29 ± 4 ml/100 g/min (p < 0.05); and E was 0.921 ± 0.025 and 0.962 ± 0.015 (p < 0.05) in the gray matter (GM) and the white matter (WM), respectively. PS was higher in the GM (171 ± 20 ml/100 g/min) compared with the WM (95 ± 18 ml/100 g/min) (p < 0.05). The parameters exhibited good reliability with test re-test experiments. The sensitivity of this technique was demonstrated by 200 mg caffeine intake, which resulted in a decrease in the resting PS by ~31%.

Imaging blood-brain barrier dysfunction: A state-of-the-art review from a clinical perspective

The blood-brain barrier (BBB) consists of specialized cells that tightly regulate the in- and outflow of molecules from the blood to brain parenchyma, protecting the brain's microenvironment. If one of the BBB components starts to fail, its dysfunction can lead to a cascade of neuroinflammatory events leading to neuronal dysfunction and degeneration. Preliminary imaging findings suggest that BBB dysfunction could serve as an early diagnostic and prognostic biomarker for a number of neurological diseases. This review aims to provide clinicians with an overview of the emerging field of BBB imaging in humans by answering three key questions: (1. Disease) In which diseases could BBB imaging be useful? (2. Device) What are currently available imaging methods for evaluating BBB integrity? And (3. Distribution) what is the potential of BBB imaging in different environments, particularly in resource limited settings? We conclude that further advances are needed, such as the validation, standardization and implementation of readily available, low-cost and non-contrast BBB imaging techniques, for BBB imaging to be a useful clinical biomarker in both resource-limited and well-resourced settings.

Regional and interindividual relationships between cerebral perfusion and oxygen metabolism

Quantitative measurements of resting cerebral blood flow (CBF) and metabolic rate of oxygen (CMRO₂) show large between-subject and regional variability, but the relationships between CBF and CMRO₂ measurements regionally and globally are not fully established. Here, we investigated the between-subject and regional associations between CBF and CMRO₂ measures with independent and quantitative PET techniques. We included resting CBF and CMRO₂ measurements from 50 healthy volunteers (aged 22-81 yr), and calculated the regional and global values of oxygen delivery (Do₂) and oxygen extraction fraction (OEF). Linear mixed-model analysis showed that CBF and CMRO₂ measurements were closely associated regionally, but no significant between-subject association could be demonstrated, even when adjusting for arterial Pco₂ and hemoglobin concentration. The analysis also showed regional differences of OEF, reflecting variable relationship between Do₂ and CMRO₂, resulting in lower estimates of OEF in thalami, brainstem, and mesial temporal cortices and higher estimates of OEF in occipital cortex. In the present study, we demonstrated no between-subject association of quantitative measurements of CBF and CMRO₂ in healthy subjects. Thus, quantitative measurements of CBF did not reflect the underlying between-subject variability of oxygen metabolism measures, mainly because of large interindividual OEF variability not accounted for by Pco₂ and hemoglobin concentration.NEW & NOTEWORTHY Using quantitative PET-measurements in healthy human subjects, we confirmed a regional association of CBF and CMRO₂, but did not find an association of these values across subjects. This suggests that subjects have an individual coupling between perfusion and metabolism and shows that absolute perfusion measurements does not serve as a surrogate measure of individual measures of oxygen metabolism. The analysis further showed smaller, but significant regional differences of oxygen extraction fraction at rest.

Measuring water exchange across the blood-brain barrier using MRI

The blood-brain barrier (BBB) regulates the transfer of solutes and essential nutrients into the brain. Growing evidence supports BBB dysfunction in a range of acute and chronic brain diseases, justifying the need for novel research and clinical tools that can non-invasively detect, characterize, and quantify BBB dysfunction in-vivo. Many approaches already exist for measuring BBB dysfunction in man using positron emission tomography and magnetic resonance imaging (e.g. dynamic contrast-enhanced MRI measurements of gadolinium leakage). This review paper focusses on MRI measurements of water exchange across the BBB, which occurs through a wide range of pathways, and is likely to be a highly sensitive marker of BBB dysfunction. Key mathematical models and acquisition methods are discussed for the two main approaches: those that utilize contrast agents to enhance relaxation rate differences between the intravascular and extravascular compartments and so enhance the sensitivity of MRI signals to BBB water exchange, and those that utilize the dynamic properties of arterial spin labelling to first isolate signal from intravascular spins and then estimate the impact of water exchange on the evolving signal. Data from studies in healthy and pathological brain tissue are discussed, in addition to validation studies in rodents.

Non-contrast MR imaging of blood-brain barrier permeability to water

PURPOSE

Many brain diseases are associated with an alteration in blood-brain barrier (BBB) and its permeability. Current methods using contrast agent are primarily sensitive to major leakage of BBB to macromolecules, but may not detect subtle changes in BBB permeability. The present study aims to develop a novel non-contrast MRI technique for the assessment of BBB permeability to water.

METHODS

The central principle is that by measuring arterially labeled blood spins that are drained into cerebral veins, water extraction fraction (E) and permeability-surface-area product (PS) of BBB can be determined. Four studies were performed. We first demonstrated the proof-of-principle using conventional ASL with very long post-labeling delays (PLD). Next, a new sequence, dubbed water-extraction-with-phase-contrast-arterial-spin-tagging (WEPCAST), and its Look-Locker (LL) version were developed. Finally, we demonstrated that the sensitivity of the technique can be significantly enhanced by acquiring the data under mild hypercapnia.

RESULTS

By combining a strong background suppression with long PLDs (2500-4500 ms), ASL spins were reliably detected in the superior sagittal sinus (SSS), demonstrating the feasibility of measuring this signal. The WEPCAST sequence eliminated partial voluming effects of tissue perfusion and allowed quantitative estimation of E = 95.5 ± 1.1% and PS = 188.9 ± 13.4 mL/100 g/min, which were in good agreement with literature reports. LL-WEPCAST sequence shortened the scan time from 19 min to 5 min while providing results consistent with multiple single-PLD acquisitions. Mild hypercapnia increased SNR by 78 ± 25% without causing a discomfort in participants.

CONCLUSION

A new non-contrast technique for the assessment of global BBB permeability was developed, which may have important clinical applications.

Measurement of vascular water transport in human subjects using time-resolved pulsed arterial spin labelling

Most approaches to arterial spin labelling (ASL) data analysis aim to provide a quantitative measure of the cerebral blood flow (CBF). This study, however, focuses on the measurement of the transfer time of blood water through the capillaries to the parenchyma (referred to as the capillary transfer time, CTT) as an alternative parameter to characterise the haemodynamics of the system. The method employed is based on a non-compartmental model, and no measurements need to be added to a common time-resolved ASL experiment. Brownian motion of labelled spins in a potential was described by a one-dimensional general Langevin equation as the starting point, and as a Fokker-Planck differential equation for the averaged distribution of labelled spins at the end point, which takes into account the effects of flow and dispersion of labelled water by the pseudorandom nature of the microvasculature and the transcapillary permeability. Multi-inversion time (multi-TI) ASL data were acquired in 14 healthy subjects on two occasions in a test-retest design, using a pulsed ASL sequence and three-dimensional gradient and spin echo (3D-GRASE) readout. Based on an error analysis to predict the size of a region of interest (ROI) required to obtain reasonably precise parameter estimates, data were analysed in two relatively large ROIs, i.e. the occipital lobe (OC) and the insular cortex (IC). The average values of CTT in OC were 260 ± 60 ms in the first experiment and 270 ± 60 ms in the second experiment. The corresponding IC values were 460 ± 130 ms and 420 ± 139 ms, respectively. Information related to the water transfer time may be important for diagnostics and follow-up of cerebral conditions or diseases characterised by a disrupted blood-brain barrier or disturbed capillary blood flow.

Radiopharmaceutical chemistry for positron emission tomography

Molecular imaging is an emerging technology that allows the visualization of interactions between molecular probes and biological targets. Molecules that either direct or are subject to homeostatic controls in biological systems could be labeled with the appropriate radioisotopes for the quantitative measurement of selected molecular interactions during normal tissue homeostasis and again after perturbations of the normal state. In particular, positron emission tomography (PET) offers picomolar sensitivity and is a fully translational technique that requires specific probes radiolabeled with a usually short-lived positron-emitting radionuclide. PET has provided the capability of measuring biological processes at the molecular and metabolic levels in vivo by the detection of the gamma rays formed as a result of the annihilation of the positrons emitted. Despite the great wealth of information that such probes can provide, the potential of PET strongly depends on the availability of suitable PET radiotracers. However, the development of new imaging probes for PET is far from trivial and radiochemistry is a major limiting factor for the field of PET. In this review, we provided an overview of the most common chemical approaches for the synthesis of PET-labeled molecules and highlighted the most recent developments and trends. The discussed PET radionuclides include ¹¹C (t₁(/)₂=20.4min), ¹³N (t₁(/)₂=9.9min), ¹⁵O (t₁(/)₂=2min), ⁶⁸Ga (t₁(/)₂=68min), ¹⁸F (t₁(/)₂=109.8min), ⁶⁴Cu (t₁(/)₂=12.7h), and ¹²⁴I (t₁(/)₂=4.12d).

Effects of CBV, CBF, and blood-brain barrier permeability on accuracy of PASL and VASO measurement

Cerebral blood flow, cerebral blood volume (CBV), and water permeability through blood-brain barrier are important hemodynamic parameters in brain physiology. Pulsed arterial spin labeling and vascular-space occupancy techniques have been used to measure regional cerebral blood flow and CBV, respectively. However, these techniques generally ignore the effects of one hemodynamic parameter on the measurement of others. For instance, the influences of CBV changes on arterial spin labeling or the permeability effects on vascular-space occupancy typically were not accounted for in the quantification of blood flow or volume. In the current work, the biophysical effects of CBV on pulsed arterial spin labeling and permeability on vascular-space occupancy signals are evaluated using a general two-compartment model. The dependence of these effects on the T(1) at various field strengths is also assessed by simulations. Results indicate that CBV has negligible to small influences on pulsed arterial spin labeling signal (<6.6% at 3 T) and permeability effects are negligible on vascular-space occupancy signal (<0.1% at 3 T) under normal physiologic conditions. In addition, CBV effect on pulsed arterial spin labeling is further diminished at high field strengths, but residual blood contamination in vascular-space occupancy signal may be enhanced at high fields due to the reduced difference between extra- and intravascular T(1) values.

Hippocampal hyperperfusion in Alzheimer's disease

Many of the regions with the earliest atrophy in Alzheimer's Disease (AD) do not show prominent deficits on functional imaging studies of flow or metabolism. This paradox may provide unique insights into the pathophysiology of AD. We sought to examine the relationship between function and atrophy in AD using MRI blood flow and anatomic imaging. 22 subjects diagnosed with AD, mean Mini Mental State Exam (MMSE) score 22.2, and 16 healthy elderly controls were imaged with a volumetric arterial spin labeling blood flow MRI technique and an anatomical imaging method using the identical spatial resolution, image orientation, and spatial encoding strategy. Cerebral blood flow (CBF) and gray matter (GM) maps derived from the imaging were transformed to a standard anatomical space. GM and CBF maps were tested for significant differences between groups. Additionally, images were tested for regions with significant mismatch of the CBF and GM differences between groups. CBF was significantly lower in the bilateral precuneus, parietal association cortex and the left inferior temporal lobe but was non-significantly increased in the hippocampus and other medial temporal structures. After correction for GM loss, CBF was significantly elevated in the hippocampus and other medial temporal structures. The hippocampus and other regions affected early in AD are characterized by elevated atrophy-corrected perfusion per cm(3) of tissue. This suggests compensatory or pathological elevation of neural activity, inflammation, or elevated production of vasodilators.

Hippocampal hyperperfusion in Alzheimer's disease

Many of the regions with the earliest atrophy in Alzheimer's Disease (AD) do not show prominent deficits on functional imaging studies of flow or metabolism. This paradox may provide unique insights into the pathophysiology of AD. We sought to examine the relationship between function and atrophy in AD using MRI blood flow and anatomic imaging. 22 subjects diagnosed with AD, mean Mini Mental State Exam (MMSE) score 22.2, and 16 healthy elderly controls were imaged with a volumetric arterial spin labeling blood flow MRI technique and an anatomical imaging method using the identical spatial resolution, image orientation, and spatial encoding strategy. Cerebral blood flow (CBF) and gray matter (GM) maps derived from the imaging were transformed to a standard anatomical space. GM and CBF maps were tested for significant differences between groups. Additionally, images were tested for regions with significant mismatch of the CBF and GM differences between groups. CBF was significantly lower in the bilateral precuneus, parietal association cortex and the left inferior temporal lobe but was non-significantly increased in the hippocampus and other medial temporal structures. After correction for GM loss, CBF was significantly elevated in the hippocampus and other medial temporal structures. The hippocampus and other regions affected early in AD are characterized by elevated atrophy-corrected perfusion per cm(3) of tissue. This suggests compensatory or pathological elevation of neural activity, inflammation, or elevated production of vasodilators.

Brain tumor perfusion: comparison of dynamic contrast enhanced magnetic resonance imaging using T1, T2, and T2* contrast, pulsed arterial spin labeling, and H2(15)O positron emission tomography

OBJECTIVES

Different techniques for measuring of perfusion are clinically available, but these are usually applied to healthy brain tissue.

MATERIAL AND METHODS

Five different techniques were used here in 12 patients with brain tumors to investigate the impact of tumor vascularization on the perfusion signal: three qualitative dynamic contrast-enhanced/susceptibility-contrast magnetic resonance imaging (DCE-MRI/DSC-MRI) techniques exploiting T(1), T(2), T(2)(*) contrast, and two quantitative techniques, pulsed arterial spin labeling (PASL) and H(2)(15)O positron emission tomography (H(2)(15)O-PET).

RESULTS

In a first approximation, a linear correlation was found between all five imaging modalities regarding the perfusion signal of both, normal brain tissue and tumor. The estimated values for tumor perfusion differed significantly between the techniques (1=methodical mean in arbitrary units): PASL: 0.83, H(2)(15)O-PET: 0.62, T(1)-DCE: 1.73, T(2)-DCE: 0.69, T(2)(*)-DSC: 0.89.

CONCLUSIONS

The tumor perfusion values, determined with different techniques are not comparable. The T(2)(*)-DSC, here applied with contrast agent presaturation of extravascular space, and PASL depict median perfusion most reliably.

Accuracy of blood flow values determined by arterial spin labeling: A validation study in isolated porcine kidneys

PURPOSE

To validate the accuracy of quantitative blood flow values determined using pulsed arterial spin labeling (ASL) in the preserved and reperfused porcine kidney.

MATERIALS AND METHODS

Ex vivo porcine kidneys were perfused with whole blood under physiological conditions, in particular including pulsatile flow. Total flow through the kidney was determined using an ultrasound flowmeter. ASL measurements at two different inversion times and four different flow rates in the range of 70-210 mL/100 mL*minute were performed. Absolute values of blood flow and arterial transit times were determined in the kidney cortex.

RESULTS

The quantitative values were in good agreement with the reference values obtained after calibration of the total flow. The greatest difference observed was 13%.

CONCLUSION

Isolated organ hemoperfusion allows validating perfusion imaging techniques. The experimental setup enables long-term radiotherapeutic or toxicological studies using noninvasive ASL to monitor blood flow quantitatively.

Corrections of arterial input function for dynamic H215O PET to assess perfusion of pelvic tumours: arterial blood sampling versus image extraction

Assessment of perfusion with 15O-labelled water (H215O) requires measurement of the arterial input function (AIF). The arterial time activity curve (TAC) measured using the peripheral sampling scheme requires corrections for delay and dispersion. In this study, parametrizations with and without arterial spillover correction for fitting of the tissue curve are evaluated. Additionally, a completely noninvasive method for generation of the AIF from a dynamic positron emission tomography (PET) acquisition is applied to assess perfusion of pelvic tumours. This method uses a volume of interest (VOI) to extract the TAC from the femoral artery. The VOI TAC is corrected for spillover using a separate tissue TAC and for recovery by determining the recovery coefficient on a coregistered CT data set. The techniques were applied in five patients with pelvic tumours who underwent a total of 11 examinations. Delay and dispersion correction of the blood TAC without arterial spillover correction yielded in seven examinations solutions inconsistent with physiology. Correction of arterial spillover increased the fitting accuracy and yielded consistent results in all patients. Generation of an AIF from PET image data was investigated as an alternative to arterial blood sampling and was shown to have an intrinsic potential to determine the AIF noninvasively and reproducibly. The AIF extracted from a VOI in a dynamic PET scan was similar in shape to the blood AIF but yielded significantly higher tissue perfusion values (mean of 104.0 +/- 52.0%) and lower partition coefficients (-31.6 +/- 24.2%). The perfusion values and partition coefficients determined with the VOI technique have to be corrected in order to compare the results with those of studies using a blood AIF.

Production of [17F]CH3F (), an improved PET tracer for rCBF measurement

Production of 17F (t1/2=65 s) in the form of [17F] F2 has been achieved using both the 20Ne(p,alpha)17F and 16O(d,n)17F reactions with 11 MeV protons and 6 MeV deuterons, respectively. Yields have proven suitable for subsequent radiosynthesis of the blood flow tracer, [17F]CH3F (>60 mCi in saline), currently in use for fast repetition human studies of regional cerebral blood flow with positron emission tomography. Thick target yields of 15 mCi /microA for protons and 44 mCi/microA for deuterons have been measured for [17F]F2.

The putative pheromone androstadienone activates cortical fields in the human brain related to social cognition

Using 15O-butanol positron emission tomography (PET), we measured regional cerebral blood flow changes in five healthy young women during exposure to androstadienone, a putative human pheromone, as well as pleasant (gamma-methyl-ionone), unpleasant (methyl-thio-butanoate), and neutral (dipropylene glycol; vehicle compound) odours. Compared with the odorous substances, androstadienone activated a widely distributed neuronal network. Two large cortical fields exhibited consistent activation in each contrast: the anterior part of the inferior lateral prefrontal cortex (PFC) and the posterior part of the superior temporal cortex (STP). Intriguingly, these areas were deactivated by gamma-methyl-ionone and methyl-thio-butanoate. These brain regions can be identified as cortical fields underlying other than olfactory functions, including various aspects of social cognition and attention.

Cerebral uptake of [ethyl-11C]vinpocetine and 1-[11C]ethanol in cynomolgous monkeys: a comparative preclinical PET study

PET provides the potential to quantify the distribution of radiolabelled drugs in the human body. In cases when radiolabelled compounds undergo metabolic transformation after administration in vivo, it is necessary to examine the kinetics and distribution of both the labeled mother compound and labeled metabolites. The objective of this study was to assess the extent by which 11C-labeled ethanol, the product arising from the de-esterification of the neuroprotective drug vinpocetine (ethyl-apovincaminate), might contribute to the regional cerebral radioactivity measured by PET after the administration of [ethyl-11C]vinpocetine. In three cynomolgous monkeys PET measurements were made after intravenous bolus injection of both [11C]vinpocetine and 1-[11C]ethanol. There was a marked difference between the regional time-activity curves of [11C]ethanol and [11C]vinpocetine. The distribution pattern obtained with [11C]ethanol was similar to that observed with blood flow tracers such as [15O]water and [15O]butanol. The study shows that although [11C]ethanol may moderately contribute to the brain radioactivity distribution pattern of [11C]vinpocetine, the rapid degradation of [11C]ethanol makes it unlikely that the contribution of this metabolite is of importance. The distinct distribution patterns and kinetics of [11C]vinpocetine and [11C]ethanol also support the view, obtained from our previous observations, that vinpocetine may bind to specific sites in the monkey and human brain, especially in the thalamus.

Interdependence of regional and global cerebral blood flow during visual stimulation: an O-15-butanol positron emission tomography study

The authors investigated the influence of variations in global cerebral blood flow (gCBF) on regional flow changes during visual stimulation. Global flow was varied using different end-expiratory CO2 values (PETCO2) between 20 and 70 mm Hg. Visual stimulation was performed with a red LED-array flashing at 8 Hz. Blood flow was measured with 0-15-butanol, continuous arterial blood sampling, and positron emission tomography (PET). Global flow changes surpassed the published values of O-15-H2O studies, better fitting the results of the inert gas technique (gCBF at 20, 40, and 70 mm Hg PETCO2 +/- SD was 31 +/- 4, 48 +/- 13, and 160 +/- 50 mL 100 g(-1) min(-1), respectively). The relation between PETCO2 and CBF in the current study was best described by an exponential rather than a linear function. At low PETCO2, the activation-induced flow changes are moderately damped, whereas at high PETCO2, they are nearly lost (deltaCBF (+/-SD): 52% +/- 25%, 68% +/- 22%, 16% +/- 25% at PETCO2 = 20, 40, 70 mm Hg, respectively).

Two-compartment exchange model for perfusion quantification using arterial spin tagging

The original well-mixed tissue model for the arterial spin tagging techniques is extended to a two-compartment model of restricted water exchange between microvascular (blood) and extravascular (tissue) space in the parenchyma. The microvascular compartment consists of arterioles, capillaries, and venules, with the blood/tissue water exchange taking place in the capillaries. It is shown that, in the case of limited water exchange, the individual FAIR (Flow-sensitive Alternating Inversion Recovery) signal intensities of the two compartments are comparable in magnitude, but are not overlapped in time. It is shown that when the limited water exchange is assumed to be fast, flows quantified from the signal-intensity difference are underestimated, an effect that becomes more significant for larger flows and higher magnetic field strengths. Experimental results on cat brain at 4.7 T comparing flow data from the FAIR signal-intensity difference with those from microspheres over a cerebral blood flow range from 15 to 150 mL 100 g(-1) min(-1) confirm these theoretic predictions. FAIR flow values with correction for restricted exchange, however, correlate well with the radioactive microsphere flow values. The limitations of the approach in terms of choice of the intercompartmental exchange rates are discussed.

Neural networks for internal reading and visual imagery of reading: a PET study

Regional cerebral blood flow (rCBF) measurements with positron emission tomography (PET) were made on 10 volunteers in rest condition as well as while the subjects, with closed eyes, (i) internally listed the letters of the alphabet and cited the first verse of the Hungarian national anthem, (ii) visualised the capital letters of the alphabet, and (iii) visualised the capital letters of the first verse of the Hungarian national anthem. Significant changes in rCBF indicated various networks of cortical neuronal populations active during the tasks. Internal listing, as compared to the rest condition, activated the left precentral gyrus. Visualising the letters of the alphabet, when compared to the rest condition, activated a cortical network comprising fields along the banks of the left and right intraparietal sulci, the left medial frontal, precentral and occipital sulci, and the right superior frontal gyrus. Visualising the letters of the anthem, when compared to the rest condition, activated a cortical network comprising fields along the banks of the left and right intraparietal sulci, the left medial and inferior frontal gyri, and the right anterior cingulate gyrus. Contrasting the two visualisation tasks revealed task specific activation in the left lateral occipital gyrus (alphabet vs. anthem visualisation) and in the left anterior cingulate gyrus (anthem vs. alphabet visualisation). The data indicate that visual imagery of letters of the alphabet or a text engages a widespread network of cortical fields in the visual association cortices and the frontal cortex, without the engagement of the primary (V1) and secondary (V2) visual cortical areas. This finding supports the hypothesis that neuronal populations engaged by visual imagery and visual perception only partially overlap. The networks, activated in the visualisation tasks, have a core which is identical in the different visualisation tasks. The core network is complemented in a task-specific manner by the recruitment of additional cortical neuronal populations.

H(2)(15)O PET validation of steady-state arterial spin tagging cerebral blood flow measurements in humans

Steady-state arterial spin tagging approaches can provide quantitative images of CBF, but have not been validated in humans. The work presented here compared CBF values measured using steady-state arterial spin tagging with CBF values measured in the same group of human subjects using the H(2)(15)O IV bolus PET method. Blood flow values determined by H(2)(15)O PET were corrected for the known effects of incomplete extraction of water across the blood brain barrier. For a cortical strip ROI, blood flow values determined using arterial spin tagging (64+/-12 cc/100 g/min) were not statistically different from corrected blood flow values determined using H(2)(15)O PET (67+/-13 cc/100 g/min). However, for a central white matter ROI, blood flow values determined using arterial spin tagging were significantly underestimated compared to corrected blood flow values determined using H(2)(15)O PET. This underestimation could be caused by an underestimation of the arterial transit time for white matter regions.

Simultaneous movements of upper and lower limbs are coordinated by motor representations that are shared by both limbs: a PET study

The purpose of this study was to examine the cerebral control of simultaneous movements of the upper and lower limbs. We examined two hypotheses on how the brain coordinates movement: (i) by the involvement of motor representations shared by both limbs; or (ii) by the engagement of specific neural populations. We used positron emission tomography to measure the relative cerebral blood flow in healthy subjects performing isolated cyclic flexion-extension movements of the wrist and ankle (i.e. movements of wrist or ankle alone), and simultaneous movements of the wrist and ankle (a rest condition was also included). The simultaneous movements were performed in the same directions (iso-directional) and in opposite directions (antidirectional). There was no difference in the brain activity between these two patterns of coordination. In several motor-related areas (e.g. the contralateral ventral premotor area, the dorsal premotor area, the supplementary motor area, the parietal operculum and the posterior parietal cortex), the representation of the isolated wrist movement overlapped with the representation of the isolated ankle movement. Importantly, the simultaneous movements activated the same set of motor-related regions that were active during the isolated movements. In the contralateral ventral premotor cortex, dorsal premotor cortex and parietal operculum, there was less activity during the simultaneous movements than for the sum of the activity for the two isolated movements (interaction analysis). Indeed, in the ventral premotor cortex and parietal operculum, the activity was practically identical regardless whether only the wrist, only the ankle, or both the wrist and the ankle were moved. Taken together, these findings suggest that interlimb coordination is mediated by motor representations shared by both limbs, rather than being mediated by specific additional neural populations.

Effect of restricted water exchange on cerebral blood flow values calculated with arterial spin tagging: a theoretical investigation

Arterial spin tagging techniques originally used the one-compartment Kety model to describe the dynamics of tagged water in the brain. The work presented here develops a more realistic model that includes the contribution of tagged water in the capillary bed and accounts for the finite time required for water to diffuse across the blood-brain barrier. The new model was used to evaluate potential errors in cerebral blood flow values calculated using the one-compartment Kety model. The results predict that if the one-compartment Kety model is used to analyze arterial spin tagging data the observed grey matter cerebral blood flow values should be relatively insensitive to restricted diffusion of water across the capillary bed. For instance, the observed grey matter cerebral blood flow should closely approximate the true cerebral blood flow and not the product of the extraction fraction and the cerebral blood flow. This prediction is in agreement with recent experimental arterial spin tagging results.

Olfactory functions are mediated by parallel and hierarchical processing

How the human brain processes the perception, discrimination, and recognition of odors has not been systematically explored. Cerebral activations were therefore studied with PET during five different olfactory tasks: monorhinal smelling of odorless air (AS), single odors (OS), discrimination of odor intensity (OD-i), discrimination of odor quality (OD-q), and odor recognition memory (OM). OS activated amygdala-piriform, orbitofrontal, insular, and cingulate cortices and right thalamus. OD-i and OD-q both engaged left insula and right cerebellum. OD-q also involved other areas, including right caudate and subiculum. OM did not activate the insula, but instead, the piriform cortex. With the exception of caudate and subiculum, it shared the remaining activations with the OD-q, and engaged, in addition, the temporal and parietal cortices. These findings indicate that olfactory functions are organized in a parallel and hierarchical manner.

Butanol is superior to water for performing positron emission tomography activation studies

[15(O)]Butanol has been shown to be superior to [15(O)]water for measuring cerebral blood flow with positron emission tomography. This work demonstrates that it is also superior for performing activation studies. Data were collected under three conditions: a visual confrontation animal-naming task, nonsense figure size discrimination, and a nonvisual darkroom control task. Time-activity curves (TAC) were obtained for regions known to be activated by the confrontation naming task to compare absolute uptake and the different kinetics of the two tracers. Also, t statistic maps were calculated from the data of 10 subjects for both tracers and compared for magnitude of change and size of activated regions. Peak uptake in the whole-brain TAC were similar for the two tracers. For all regions and conditions, the washout rate of [15(O)]butanol was 41% greater than that of [15(O)]water. At a threshold of 0, the [15(O)]water and [15(O)]butanol percent difference (nonnormalized) and t statistic (global normalization) images are nearly identical, indicating that the same property is being measured with both tracers. The [15(O)]butanol parametric images displayed at a threshold of /t/ = 5 look similar to the [15(O)]water parametric maps displayed at a threshold of /t/ = 4, which is consistent with the observation that t statistic values in [15(O)]butanol images are generally greater. The t statistic values were equal when the [15(O)]butanol parametric map was created from any subset of 6 subjects and the [15(O)]water parametric map was created from all 10 subjects. Fewer subjects need to be studied with [15(O)]butanol to reach the same statistical power as an [15(O)]water-based study.

Effect of partition coefficient, permeability surface product, and radioisotope on the signal-to-noise ratio in PET functional brain mapping: a computer simulation

In this work we use a computer simulation to estimate the magnitude of improvement in the signal-to-noise ratio of PET functional brain mapping studies as a function of partition coefficient and permeability surface product for O-14, F-17, and O-15 labeled flow tracers. A model for signal-to-noise ratio is derived from the Kety model for inert diffusible blood flow tracers. The results of the simulation suggest that moderate increases in partition coefficient and permeability surface product compared with water would lead to an increase in signal-to-noise ratio of a factor of about 3.

Cross-modal transfer of information between the tactile and the visual representations in the human brain: A positron emission tomographic study

Positron emission tomography in three-dimensional acquisition mode was used to identify the neural populations involved in tactile-visual cross-modal transfer of shape. Eight young male volunteers went through three runs of three different matching conditions: tactile-tactile (TT), tactile-visual (TV), and visual-visual (VV), and a motor control condition. Fifteen spherical ellipsoids were used as stimuli. By subtracting the different matching conditions and calculating the intersections of statistically significant activations, we could identify cortical functional fields involved in the formation of visual and tactile representation of the objects alone and those involved in cross-modal transfer of the shapes of the objects. Fields engaged in representation of visual shape, revealed in VV-control, TV-control and TV-TT, were found bilaterally in the lingual, fusiform, and middle occipital gyri and the cuneus. Fields engaged in the formation of the tactile representation of shape, appearing in TT-control, TV-control and TV-VV, were found in the left postcentral gyrus, left superior parietal lobule, and right cerebellum. Finally, fields active in both TV-VV and TV-TT were considered as those involved in cross-modal transfer of information. One field was found, situated in the right insula-claustrum. This region has been shown to be activated in other studies involving cross-modal transfer of information. The claustrum may play an important role in cross-modal matching, because it receives and gives rise to multimodal cortical projections. We propose here that modality-specific areas can communicate, exchange information, and interact via the claustrum.

Visual form discrimination from texture cues: a PET study

With the purpose of localising the cerebral cortical areas participating in the discrimination of visual form generated exclusively by texture cues, we measured changes in regional cerebral blood flow (rCBF) with positron emissions tomography (PET) and 15O-butanol as the tracer. The subjects performed two odd-one-out discrimination tasks: a form-from-texture discrimination task (in which a visual form was defined by differences in texture) and its reference task, the discrimination of texture. During task performance, activated fields were present bilaterally in the primary visual cortex and its immediate extrastriate cortex, the right lateral occipital gyrus, bilaterally in the fusiform and superior temporal gyri and posterior parts of the superior parietal lobules, along the medial bank of the right intraparietal sulcus, and in the right supramarginal gyrus. Other fields were found in the cingulate and prefrontal cortex. The findings demonstrate that the discrimination of visual form as defined by texture engages cortical fields that are widely distributed ion the human brain. In the visual cortex, the activated fields are present in both the occipito-temporal and occipito-parietal visual areas. These results suggest that the perception and discrimination of forms in the visual system requires the joint-activation of neuronal populations in the visual cortex.

Understanding functional neuroimaging methods based on neurovascular coupling

Functional neuroimaging techniques are usually grouped according to the employed apparatus into functional magnetic resonance imaging techniques (fMRI), nuclear medicine approaches such as single photon emission tomography (SPET) or positron emission tomography (PET), and optical approaches (measurement of intrinsic signals, near infrared spectroscopy (NIRS)). However, the physiological parameters that are measured with these methods do not necessarily follow this technical classification. On the one hand, using different imaging modalities the same physiological parameters are measured and on the other hand, using the same imaging devices completely different physiological parameters can be assessed. The present article covers those functional neuroimaging methods which measure the vascular response to functional brain activation (PET, SPET, fMRI and NIRS). First, starting with the traditional grouping of these methods, it is outlined how the specific methods assess vascular changes associated with brain activation in order to localize brain function. Based on the understanding of the underlying physiological events, subsequently, a new classification of functional neuroimaging methods is proposed.

Quantitation of regional cerebral blood flow with 15O-butanol and positron emission tomography in humans

We describe the implementation and validation of a combined dynamic-autoradiographic approach for measuring the regional cerebral blood flow (rCBF) with 15O-butanol. From arterial blood data sampled at a rate of 1 s and list mode data of the cerebral radioactivity accumulated over 100 s, the time shift between blood and tissue curves, the dispersion constant DC, the partition coefficient p, and the CBF were estimated by least squares fitting. Using the fit results, a pixel-by-pixel parametrization of rCBF was computed for a single 40-s (autoradiographic) 15O-butanol uptake image. The mean global CBF found in 27 healthy subjects was 49 +/- 8 ml 100 g-1 min-1. Gray and white matter rCBF were 83 +/- 20 and 16 +/- 3 ml 100 g-1 min-1, respectively, with a corresponding partition coefficient p of 0.77 +/- 0.18 and 0.77 +/- 0.29 ml/g in both compartments. The quantitative images resulted in a significantly higher gray matter rCBF than the autoradiographic images.

Frequency-dependent changes of regional cerebral blood flow during finger movements

To study the effect of the repetition rate of a simple movement on the distribution and magnitude of neuronal recruitment, we measured regional CBF (rCBF) in eight normal volunteers, using positron emission tomography and 15O-labeled water. An auditory-cued, repetitive flexion movement of the right index finger against the thumb was performed at very slow (0.25 and 0.5 Hz), slow (0.75 and 1 Hz), fast (2 and 2.5 Hz), and very fast (3 and 4 Hz) rates. The increase of rCBF during movement relative to the resting condition was calculated for each pair of movement conditions. Left primary sensorimotor cortex showed no significant activation at the very slow rates. There was a rapid rise of rCBF between the slow and the fast rates, but no further increase at the very fast rates. The right cerebellum showed similar changes. Changes in the left primary sensorimotor cortex and the cerebellum likely reflect the effect of the movement rate. The posterior supplementary motor area (SMA) showed its highest activation at the very slow rates but no significant activation at the very fast rates. Changes correlating with those in the SMA were found in the anterior cingulate gyrus, right prefrontal area, and right thalamus. The decreases in CBF may reflect a progressive change in performance from reactive to predictive.

Positron-emission tomography studies of cross-modality inhibition in selective attentional tasks: closing the "mind's eye"

It is a familiar experience that we tend to close our eyes or divert our gaze when concentrating attention on cognitively demanding tasks. We report on the brain activity correlates of directing attention away from potentially competing visual processing and toward processing in another sensory modality. Results are reported from a series of positron-emission tomography studies of the human brain engaged in somatosensory tasks, in both "eyes open" and "eyes closed" conditions. During these tasks, there was a significant decrease in the regional cerebral blood flow in the visual cortex, which occurred irrespective of whether subjects had to close their eyes or were instructed to keep their eyes open. These task-related deactivations of the association areas belonging to the nonrelevant sensory modality were interpreted as being due to decreased metabolic activity. Previous research has clearly demonstrated selective activation of cortical regions involved in attention-demanding modality-specific tasks; however, the other side of this story appears to be one of selective deactivation of unattended areas.

Representation and identity - convergence of brain research and mind-brain philosophy

The localization or representation of mental abilities in the brain have always been considered as key questions for understanding the organization of the human nervous system. Particularly with the advent of modern electrophysiological and imaging techniques that provide maps of electromagnetic fields and metabolic processes on the living central nervous system, the representation theory is experiencing a scientific renaissance in neurology, but is only one theory, however, in the succession of a long philosophical tradition dealing with the possible identification of mental phenomena and brain processes. This dichotomy was formulated at the latest in the Cartesian dualism of res cogitans and res extensa of the mind-body problem. Nowadays philosophical discussion, on the contrary, is dominated by monistic concepts that attempt to explain the mental realm on an organic foundation in order not to succumb to the problem of a psychophysical dualism. Of these, the identity theory offers a philosophically plausible concept postulating that the identity of brain conditions and mental phenomena is based on organic foundations. In this theory, the efforts of brain research converge on the representations of mental phenomena in the human nervous system. In a comprehensive approach, both concepts could complement each other.

Processing and analysis of form, colour and binocular disparity in the human brain: functional anatomy by positron emission tomography

With the purpose of mapping those anatomical structures participating in the processing and analysis of form, colour and disparity information, we have measured, with positron emission tomography and [15O]butanol, regional cerebral blood flow (rCBF) as an indicator of regional cerebral metabolic activity in 13 right-handed male volunteers during visual discrimination of colour, form and disparity information. The brain images were anatomically standardized using a computerized brain atlas and statistically significant changes were localized by cluster analysis. The changes in rCBF between specific activation and reference states were measured and the volumes of changes were determined, as were the loci and volumes of areas commonly activated by two or three different tasks. Each of the tasks activated over a dozen distinct and separate fields in the cortex--in the occipital, parietal, temporal and frontal lobes as well as the cerebellum. A number of overlapping fields were commonly activated in two tasks (four in the form and colour tasks, five in the form and disparity tasks, and eleven in the colour and disparity tasks), and two field overlaps were present in all three tasks (in the right superior frontal and left lingual gyri). These findings indicate that, in a visual discrimination task, the processing and analysis of single visual submodalities take place in a number of cortical fields in the human brain. As the same visual submodality is processed and analysed by numerous fields and the same field may participate in the processing of different submodalities, a divergence-convergence pattern of information processing is present in the human brain. This observation supports a hypothesis based on earlier studies in primates, namely that information processing in the visual system requires the concerted activation of a relatively large number of fields of functional networks in the brain.

Visual form discrimination from color or motion cues: functional anatomy by positron emission tomography

To explore the extent to which various cortical functional pathways are involved in processing and analyzing different types of information that yield the same perceptual entity, we mapped anatomical structures in the human brain participating in the discrimination of visual forms mediated either by motion or color cues. Changes in regional cerebral blood flow were measured in 10 young male volunteers with positron emission tomography and with [15O]butanol. During the measurements, the subjects performed four visual discrimination tasks (form-from-motion, motion alone, form-from-color, and color alone discrimination). The individual regional cerebral blood flow images were standardized in shape and size with the help of a computerized brain atlas. Subtraction images were determined and averaged across data from all subjects. The resulting images were analyzed for statistically significant changes between specific and reference tasks. The discrimination of form by means of motion cues activated functional fields bilaterally in the inferior and lateral occipital gyri, in the lingual, anterior cingulate, middle frontal and orbitofrontal gyri, and in the left fusiform and right inferior temporal gyri. Form discrimination by color cues resulted in activation bilaterally in the inferior temporal, lateral occipital, and orbitofrontal gyri, the left precuneus and intraparietal sulcus, and the right precentral gyrus. The regions engaged in the two kinds of form discrimination did not overlap, demonstrating that differences in visual forms mediated by color or motion cues are processed and analyzed by disparate networks of functional fields in human cerebral cortex.

Radiopharmaceuticals for brain imaging

Brain imaging is performed using radiopharmaceuticals by single photon emission computed tomography (SPECT) and positron emission tomography (PET). SPECT and PET radiopharmaceuticals are classified according to blood-brain-barrier permeability, cerebral perfusion and metabolism receptor-binding, and antigen-antibody binding. The blood-brain-barrier (BBB) SPECT agents, such as 99mTcO4-, [99mTc]DTPA, 201TI and [67Ga]citrate are excluded by normal brain cells, but enter into tumor cells because of altered BBB. These agents were used in the earlier period for the detection of brain tumors. SPECT perfusion agents such as [123I]IMP, [99mTc]HMPAO, [99mTc]ECD are lipophilic agents and therefore, diffuse into the normal brain. These tracers have been successfully used to detect various cerebrovascular diseases such as stroke, Parkinson disease, Huntington's disease, epilepsy, dementia, and psychiatric disorders. Xenon-133 and radiolabeled microspheres have been used for the measurement of cerebral blood flow (CBF). Important receptor-binding SPECT radiopharmaceuticals include [123I]QNE, [123I]IBZM, and [123I]iomazenil. These tracers bind to specific receptors in the brain, thus displaying their distribution in various receptor-related cerebral diseases. Radioiodinated monoclonal antibodies were used for the detection of brain tumors. PET radiopharmaceuticals for brain imaging are commonly labeled with positron-emitters such as 11C, 13N, 15O, and 18F, although other radionuclides such as 82Rb, 62Cu and 68Ga also were used. The brain uptake of [13N]glutamate, [68Ga]EDTA and [82Rb]RbCl depends on the BBB permeability, but these are rarely used for brain imaging. Several cerebral perfusion agents have been introduced, of which [15O]water, [13N]ammonia, and [15O]butanol have been used more frequently. Regional CBF has been quantitated by using these tracers in normal and different cerebral disease states. Other perfusion agents include [15O]O2, [11C]CO, [11C]CO2, [18F]fluoromethane, [15O]O2, [11C]butanol, and [62Cu]PTSM. Among the PET cerebral metabolic agents, [18F]fluorodeoxyglucose (FDG) is most commonly used to detect metabolic abnormalities in the brain. Various brain tumors have been graded by [18F]FDG PET. This technique was used to detect epileptic foci by showing increased uptake in the foci during the ictal period and decreased uptake in the interictal period. Differentiation between recurrent tumors and radiation necrosis and the detection of Alzheimer's disease have been made successfully by [18F]FDG PET. Other PET metabolic agents such as [11C]deoxyglucose, and [11C]methylmethionine have drawn attention in the detection of brain tumors. [18F]fluorodopa is a cerebral neurotransmitter agent, which has been found very useful in the detection of Parkinson disease that shows reduced uptake of the tracer in the striatum of the brain.(ABSTRACT TRUNCATED AT 400 WORDS)

Binocular disparity discrimination in human cerebral cortex: functional anatomy by positron emission tomography

Neurobiological studies in higher primates indicate that the processing of stereoscopic information takes place at early levels in the visual cortex. To map the anatomical structures in the human brain participating in pure stereopsis based upon binocular disparity, we measured with positron emission tomography the changes in regional cerebral blood flow as an indicator of metabolic activity in 10 healthy young men during visual discrimination of binocular disparity. The data demonstrate that the discrimination of pure stereo-optic disparity information takes place in the polar striate cortex and the neighboring peri-striate cortices, as well as in the parietal lobe, the prefrontal cortex, and the cerebellum. The discrimination of stereoscopic depth is dependent on a network composed of multiple functional fields localized in occipital- and parietal-lobe visual areas as well as in the dorsolateral and mesial prefrontal cortex. The findings support the importance of coactivated occipitoparietal visual areas in the processing and analysis of binocular depth information in humans.

A PET study of somatosensory discrimination in man. microgeometry versus macrogeometry

The regional cerebral blood flow (rCBF) was measured with 15O-butanol and positron emission tomography (PET) in 10 healthy subjects in order to compare cerebral activation involved in the somatosensory discrimination of microgeometric features with cerebral activation associated with the discrimination of macrogeometric features. Subjects performed two-alternative forced choice (2-AFC) discriminations of pairs of stimuli from a series of quantified standardized stimuli that differed in roughness (microgeometry), and a separate 2-AFC task of smooth tactile stimuli that differed in length (macrogeometry). Results are presented from three conditions: (1) a roughness discrimination task; (2) a length discrimination task; and (3) a control trial in which subjects were required to reproduce similar exploratory finger movements only, but without a specific stimulus to feel. Mean subtraction images were computed using the computerized adjustable brain atlas of Greitz et al. (1991, J. Comput. Assisted Tomogr., 15, 26-38) and areas of significant blood flow change were identified. Both the roughness and the length discrimination tasks activated overlapping cortical fields contralaterally in the anterior and posterior lip of the postcentral sulcus. However, in the length discrimination, activation of the posterior lip of the postcentral sulcus extended deeper into the sulcus and there was also a separate additional area of activation in the anterior part of the precentral gyrus. Furthermore, the length discrimination task activated fields in the overt part of the supramarginal gyrus bilaterally as well as fields in the angular gyrus bilaterally. Thus roughness discrimination uses only a subset of the cortical regions that are needed for the recovery of length information, which requires more extensive somatosensory processing. This finding may be partly explained in that length perception needs both edge detection of the stimuli used, as well as integrated information of surface length and velocity, which is not necessary for roughness perception. Specific differences in the acquisition of necessary tactile information between the two discrimination tasks was reflected in different sampling strategies.