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Biomedical subjects

I Kanno

Publications and source records attributed to I Kanno.

At least 19 recordsLinked to original sources

Regional cerebral blood flow, blood volume, oxygen extraction fraction, and oxygen utilization rate in normal volunteers measured by the autoradiographic technique and the single breath inhalation method.

By means of a high resolution PET scanner, the regional cerebral blood flow (rCBF), cerebral blood volume (rCBV), oxygen extraction fraction (rOEF), and metabolic rate of oxygen (rCMRO2) for major cerebral gyri and deep brain structures were studied in eleven normal volunteers during an eye-covered and ear-unplugged resting condition. Regional CBF was measured by the autoradiographic method after intravenous administration of H2(15)O. Regional OEF and rCMRO2 were measured by the single inhalation of 15O2. With MR T1-weighted images as an anatomical reference, thirteen major cerebral gyri, caudate nucleus, lentiform nucleus, thalamus, midbrain, pons, cerebellum and vermis were defined on the CMRO2 images. Values were read by using circular regions of interest 16 mm in diameter. The posterior part of the cingulate gyri had the highest rCBF and rCMRO2 values among brain structures, followed by the lentiform nucleus, the cerebellum, the caudate nucleus, and the thalamus. Parahippocampal gyri had the lowest rCBF and rCMRO2 values among the cortical gyri. Regional OEF for the pontine nuclei (0.34 +/- 0.04), the midbrain (0.35 +/- 0.05), the parahippocampal gyri (0.35 +/- 0.04 for the right and 0.37 +/- 0.05 for the left), and the thalami (0.37 +/- 0.05 for the right and 0.36 +/- 0.04 for the left) were significantly lower than the mean OEF for the cerebral cortices (0.42 +/- 0.04) (p < 0.05 or less). The global CBF and CMRO2 were consistent with those obtained by the Kety-Schmidt method.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Photic stimulation study of changing the arterial partial pressure level of carbon dioxide.

To investigate the effect of the level of baseline cerebral blood flow (CBF) on local CBF augmentation by activation, we have used positron emission tomography to measure regional CBF (rCBF) in 12 normal volunteers with and without photic stimulation during hypocapnia, normocapnia, and hypercapnia. The increase in rCBF in the primary visual cortex by photic stimulation was 10.8 +/- 3.1, 18.6 +/- 9.3, and 19.5 +/- 6.1 ml 100 ml-1 min-1 in hypo-, normo-, and hypercapnia, respectively. The increase was significantly smaller in hypocapnia than in normocapnia (p < 0.005). The fractional CBF increase caused by the photic stimulation was the same in all breathing conditions. This result indicates that the magnitude of the CBF increase induced by neuronal activity correlates proportionally with the level of baseline CBF.

Adult

Commentary and opinion: I. Principal component analysis, variance partitioning, and "functional connectivity".

We briefly review the need for careful study of "variance partitioning" and "optimal model selection" in functional positron emission tomography (PET) data analysis, emphasizing the use of principal component analysis (PCA) and the importance of data analytic techniques that allow for heterogeneous spatial covariance structures. Using an [15O]water dataset, we demonstrate that--even after data processing--the intrasubject signal component of primary interest in baseline activation studies constitutes a very small fraction of the intersubject variance. This small intrasubject variance component is subtly but significantly changed by using analysis of covariance instead of scaled subprofile model processing before applying PCA. Finally, we argue that the concept of "functional connectivity" should be interpreted very generally until the relative roles of inter- and intrasubject variability in both disease and normal PET datasets are better understood.

Analysis of Variance

Acute subarachnoid hemorrhage: MR imaging with fluid-attenuated inversion recovery pulse sequences.

PURPOSE: To evaluate the usefulness of fluid-attenuated inversion recovery (FLAIR) magnetic resonance (MR) imaging sequences in the detection of acute subarachnoid hemorrhage (SAH). MATERIALS AND METHODS: MR imaging with FLAIR sequences was performed with a 0.5-T superconducting unit in 20 patients (aged 30-72 years) with acute SAH due to a ruptured aneurysm and in 27 control subjects (aged 32-72 years). FLAIR images were obtained 2 hours to 2 days after ictus. Findings were evaluated and compared with computed tomographic (CT) findings. RESULTS: In all patients, acute SAH was clearly demonstrated as an area with signal intensity that was high relative to that of the normal cerebrospinal fluid and surrounding brain parenchyma at FLAIR imaging. This sequence was especially useful in demonstration of acute SAH in the posterior fossa, which was difficult to show at CT because of beam-hardening artifacts. In a double-blind comparison, no FLAIR images acquired in control subjects were confused with those acquired in control subjects were confused with those acquired in patients. CONCLUSION: FLAIR sequences reliably provide diagnostic images in patients with acute SAH.

Acute Disease

Human cortical regions activated by wide-field visual motion: an H2(15)O PET study.

1. Several areas in the monkey dorsal visual pathway, including the dorsal part of the medial superior temporal area, have been found to contain cells responding to movements of a wide visual field and are suggested to be involved in analyzing self-induced motion information. In the present study, positron emission tomography was used to localize human cortical regions responding to wide-field visual motion. Changes in regional cerebral blood flow (rCBF) were measured when subjects maintained fixation and viewed low-contrast (0.15 log units brighter than the background) dots subtending 80 x 80 degrees and moving either coherently or incoherently. Brain foci were localized after activity in a fixation-only paradigm was subtracted from that in the two moving dot paradigms. 2. Both the coherent and incoherent movements significantly activated the primary/secondary visual cortex and surrounding visual areas in the cuneus and superior occipital gyrus. Subtraction of images between the coherent and incoherent movements showed that the activity caused by the two types of movement was comparable in these early visual cortical regions. 3. In the lateral occipitotemporoparietal cortex, the coherent movement specifically activated two separate areas; a posterior focus was located at the border of the right occipitotemporal gyri, and a dorsoanterior focus was located bilaterally in the temporoparietal cortex. The incoherent movement did not activate these regions. 4. A fine anatomic localization using individual magnetic resonance images was performed for the bilateral activation in the temporoparietal cortex, which was found to be located mainly in the depth of the inferior parietal lobule and a small portion of the superior and middle temporal gyri. 5. Both the coherent and incoherent movements activated a part of the superior parietal lobule located within the intraparietal sulcus (Brodmann area 7). The bilateral foci activated by the coherent movement were located more anteriorly than the focus activated by the incoherent movement. Subtraction images between the coherent and incoherent movements, however, did not reveal any significant rCBF increases in the superior parietal lobule. 6. Several other cortical regions known to be involved in visuospatial and visuomotor functions were also activated by the coherent movement, including the frontal eye field (Brodmann area 8) and premotor cortex (Brodmann area 6) in the frontal lobe. 7. The posteriorly located activation at the border of occipito-temporal gyri corresponds to the homologue of the middle temporal area reported in previous activation studies using small to medium-sized motion stimuli. The bilateral activation in the inferior parietal lobule appeared to rely on wide-field motion stimulation.

Adult

Central benzodiazepine receptor distribution after subcortical hemorrhage evaluated by means of [123I]iomazenil and SPECT.

BACKGROUND AND PURPOSE: [123I]Iomazenil is a single-photon emission computed tomography (SPECT) tracer that selectively binds to central benzodiazepine receptor in the neuron membrane. With this ligand, we studied the central benzodiazepine receptor distribution in the cortex remote from subcortical hematoma in intracerebral hemorrhage patients. METHODS: Four patients with unilateral putaminal hemorrhage and one patient with right thalamic hemorrhage were studied (mean +/- 1 SD age, 50.0 +/- 8.8 years). The initial volume of hematoma ranged from 4.3 to 31.0 mL (mean +/- 1 SD, 17.5 +/- 12.3 mL). SPECT images obtained 3 hours after intravenous administration of [123I]iomazenil (167 MBq/750 ng) were analyzed. In three patients, perfusion was evaluated with [123I]IMP. On SPECT images, the radioactivity ratio of the ipsilateral to the contralateral cerebral cortex (I/C ratio) or of the contralateral to the ipsilateral cerebellar hemisphere (C/I ratio) was measured. RESULTS: The I/C ratio for iomazenil was significantly decreased compared with unity in the temporal lobe (0.84 +/- 0.08, P < .01) and the parietal lobe (0.87 +/- 0.10, P < .05), but the C/I ratio in the cerebellum (1.00 +/- 0.03) was not. The C/I ratio for perfusion in the cerebellar cortex (0.83 +/- 0.04, P < .01) was significantly decreased compared with that in normal subjects. CONCLUSIONS: Central benzodiazepine receptor-[123I]iomazenil binding was decreased in the ipsilateral cerebral cortex remote from the subcortical hematoma. This preliminary result may facilitate further study of the potential damage of the cortical neurons remote from subcortical hematoma.

Cerebral Cortex

MR diagnosis of subacute and chronic subarachnoid hemorrhage: comparison with CT.

OBJECTIVE: The purpose of our study was to compare the value of MR imaging with CT in the diagnosis of subarachnoid hemorrhage in the subacute and chronic stages (> 3 days after the hemorrhagic episode). MATERIALS AND METHODS: We performed 42 MR examinations using a 0.5-T unit in 37 patients with subarachnoid hemorrhage caused by a ruptured aneurysm. Examinations were done 4-75 days after the ictus. We obtained 40 T1-weighted, 11 proton density-weighted, 15 T2-weighted, and 28 moderately T2-weighted images. CT was also performed in all patients within 24 hr of the MR examination. Confirmation of the presence of subarachnoid hemorrhage at the time of the MR examination was made by CSF examination using lumbar puncture or surgical findings. RESULTS: In the subacute and chronic stages, subarachnoid hemorrhage was seen as an area of high signal intensity on T1-weighted, proton density-weighted, T2-weighted, and moderately T2-weighted MR images in 63%, 90%, 25%, and 92% of cases, respectively. On CT scans, subarachnoid hemorrhage was seen as an area of high attenuation in only 46% of cases. Especially in the chronic stage, subarachnoid hemorrhage was seen as an area of high signal intensity more frequently by MR imaging than by CT (90% on T1-weighted images; 100% on proton density-weighted images; 25% on T2-weighted images; 100% on moderately T2-weighted images; and 10% on CT scans). High-signal-intensity subarachnoid hemorrhage was demonstrated by MR imaging until a maximum of 39 days after the ictus, whereas high-attenuation subarachnoid hemorrhage was demonstrated by CT until a maximum of 17 days after the ictus. CONCLUSIONS: Our findings show that MR imaging is superior to CT for the diagnosis of subacute and chronic subarachnoid hemorrhage. MR imaging is especially useful for the diagnosis of chronic subarachnoid hemorrhage.

Acute Disease

Rapid calculation of regional cerebral blood flow and distribution volume using iodine-123-iodoamphetamine and dynamic SPECT.

UNLABELLED: Iodine-123-iodoamphetamine (IMP) is commonly used as a flow tracer for SPECT due to its large first-pass extraction fraction. Significant clearance from the brain, however, causes changes in distribution and underestimation of CBF values when a conventional microsphere model is applied to prolonged data acquisition. We have developed a rapid method to calculate CBF images in which clearance effects are taken into account. METHODS: A dynamic SPECT scan was obtained from five subjects (four patients with cerebral infarctions and one healthy volunteer) following intravenous injection of IMP lasting 1 min. The arterial input function was obtained by frequent blood sampling and measurement of the octanol extraction ratio. The dynamic images were weighted and integrated so that the look-up table procedures yielded values of CBF and distribution volume (Vd) simultaneously. RESULTS: Calculated values for CBF and Vd were consistent with those determined by nonlinear least squares fitting [CBF: Y = 1.03X-0.30 (ml/100 ml/min), r = 0.998, p < 0.001; Vd: Y = 0.99X-0.11 (ml/ml), r = 0.99, p < 0.001] and calculated CBF correlated significantly with CBF measured by PET [Y = 0.85X-0.15 (ml/100 ml/min), r = 0.92, p < 0.001]. CONCLUSION: This technique is valid for estimating CBF.

Amphetamines

[Evaluation of partial volume effect in quantitative measurement of regional cerebral blood flow in single photon emission computed tomography--effects of limited spatial resolution and first-pass extraction fraction].

Two numerical brain phantoms were generated in order to investigate errors which might be included in the quantitative measurement of regional CBF with use of single photon emission computed tomography (SPECT). The first phantom simulated the normal brain, and effects of the limited spatial resolution of the SPECT scanner were evaluated for 4 tracer kinetic models of the conventional microsphere model, the intra-carotid bolus injection technique of 133Xe, 133Xe Kanno-Lassen method, and the IMP-autoradiography (IMP-ARG) method. The second phantom simulated the diseased brain with middle-carotid artery (MCA) occlusion, and effects of the limited first-pass extraction fraction were investigated for the microsphere model with various permeability-surface area products. The limited spatial resolution caused systematic underestimation of the radioactivity concentration in the gray matter regions, and systematic overestimation in the low CBF regions. These errors in the original radioactivity distribution were found to cause further systematic errors in the calculated regional CBF images. It was also found that these errors were highly dependent on the tracer kinetic model employed, e.g., regional CBF values were overestimated in the clearance and the Kanno-Lassen methods compared with the conventional microsphere method, whereas values were underestimated in the IMP-ARG method. It was also shown in this study that the limited first-pass extraction fraction caused significant underestimation in the calculated rCBF values. In addition, regional contrast can be reduced when using a tracer with small PS product.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain

[Evaluation of partial volume effect in quantitative measurement of regional cerebral blood flow using positron emission tomography].

Effects of limited spatial resolution of the positron emission tomography (PET) scanner on the quantitative measurement of regional cerebral blood flow (rCBF) was investigated for various tracer kinetic models with use of 15O labeled water and PET. Using a numerical brain phantom consisting of a gray matter, white matter and cerebrospinal fluid components, dynamical tracer distribution images were calculated for the H215O bolus injection and for the C15O2 gas inhalation protocols. The tracer distribution images were convoluted with a 2 dimensional gaussian function with full-width at half maximum (FWHM) of 4, 7, 12 mm to simulate a limited spatial resolution of the PET scanner, and rCBF images were calculated according to some kinetic models. Smoothing the tracer distribution images caused a heterogeneous structure (tissue mixture) in a given volume element. rCBF values calculated by models with use of 15O-water and PET were found to provide rCBF values that were systematically underestimated compared with those obtained by the microsphere model for a mixed tissue region. Moreover, the magnitude of the underestimation was shown to be highly dependent on the tracer kinetic models employed, those errors for mixed tissue of gray and white matter were 20% on steady state, 9% on autoradiography and on weighted integration method, and 2% on non-linear least squares fitting, compared with microsphere model. More errors observed by steady state method and autoradiography method happened for tissue mixture consisting gray matter, white matter and cerebrospinal fluid components. It is important to take into account for difference of the partial volume effect for each models in calculated rCBF.

Brain

Aging effect on neutral amino acid transport at the blood-brain barrier measured with L-[2-18F]-fluorophenylalanine and PET.

UNLABELLED: Neutral amino acids (NAAs) are transported from the blood to the brain using the same carrier system in a competitive fashion. The purpose of this study is to establish a method for evaluating neutral amino acid transport at the blood-brain barrier (BBB) in humans and to examine the aging effect of amino acid transport. METHODS: A dynamic PET study with L-(2-18F)-fluorophenylalanine (18F-Phe) was performed in 14 normal volunteers (age 21-71 yr; mean +/- s.d., age range 48.0 +/- 17.1 yr). By using a two-compartment model analysis and a weighted integration technique, the influx rate constant K1, the efflux rate constant k2 and distribution volume Vd of 18F-Phe were estimated in various brain structures. RESULTS: The value of K1 was inversely correlated with plasma NAA concentration (r = -0.69, p < 0.01). The cerebellum showed the highest value of K1, while the white matter showed the lowest. There was no significant change in K1 during aging. The value of k2 was significantly increased with age. CONCLUSION: No decline of K1 during aging indicated that NAA transport from the blood to the brain is a limiting process of age in amino acid incorporation. Fluorine-18-Phe PET imaging is a feasible method to study NAA transport at the BBB in vivo in humans and can be applied to pathological conditions of the brain.

Adult

A method to quantitate cerebral blood flow using a rotating gamma camera and iodine-123 iodoamphetamine with one blood sampling.

A method has been developed to quantitate regional cerebral blood blow (rCBF) using iodine-123-labelled N-isopropyl-p-iodoamphetamine (IMP). This technique requires only two single-photon emission tomography (SPET) scans and one blood sample. Based on a two-compartment model, radioactivity concentrations in the brain for each scan time (early: t(e); delayed: td are described as: [formula: see text] respectively, where x denotes the convolution integral; Ca(t), the arterial input function; f, rCBF; and Vd, the regional distribution volume of IMP. Calculation of the ratio of the above two equations and a "table look-up" procedure yield a unique pair of rCBF and Vd for each region of interest (ROI). A standard input function has been generated by combining the input functions from 12 independent studies prior to this work to avoid frequent arterial blood sampling, and one blood sample is taken at 10 min following IMP administration for calibration of the standard arterial input function. This calibration time was determined such that the integration of the first 40 min of the calibrated, combined input function agreed best with those from 12 individual input functions (the difference was 5.3% on average). This method was applied to eight subjects (two normals and six patients with cerebral infarction), and yielded rCBF values which agreed well with those obtained by a positron emission tomography H2(15)O autoradiography method. This method was also found to provide rCBF values that were consistent with those obtained by the non-linear least squares fitting technique and those obtained by conventional microsphere model analysis. The optimum SPET scan times were found to be 40 and 180 min for the early and delayed scans, respectively. These scan times allow the use of a conventional rotating gamma camera for clinical purposes. Vd values ranged between 10 and 40 ml/g depending on the pathological condition, thereby suggesting the importance of measuring Vd for each ROI. In conclusion, optimization of the blood sampling time and the scanning time enabled quantitative measurement of rCBF with two SPET scans and one blood sample.

Aged

Comparison of anatomical standardization methods regarding the sensorimotor foci localization and between-subject variation in H2(15)O PET activation, a three-center collaboration study.

Identical sets of H2(15)O-PET brain activation data regarding vibrotactile stimulation and voluntary motion of the fingers in seven young normal subjects, together with the MRI, were analyzed in three PET centers by means of each center's own method of anatomical standardization to Talairach's frame. Every center used a linear or segmentally linear transformation with various number of scaling factors. A variation of 6-8 mm in each axis was observed in the foci localization due to the difference in the transformation principle and the measured brain size. Between-subject variation was similar in all the centers. Since different standardization methods define different coordinate systems, a cautious attitude should be taken to comparing results analyzed at different centers.

Adult

Accumulation of L-[2-(F-18)]fluorophenylalanine in peri-infarct area in a patient with acute cerebral infarction.

We studied the brain uptake of amino acid in a patient with acute cerebral infarction with L-[2-(F-18)]fluorophenylalanine and positron emission tomography. The increased accumulation of the ligand was specifically found in the peri-infarct area where oxygen metabolism was still maintained but decreased later in the 72-day follow-up period. The kinetic analysis revealed that increased accumulation was not due to increased transport from the blood to the brain but delayed washout from the brain to the blood. Although the mechanism is still unknown, abnormally high accumulation of L-[F-18]fluorophenylalanine may predict delayed neuronal changes after ischemic insults of the brain.

Aged

Methionine PET for follow-up of radiation therapy of primary lymphoma of the brain.

Positron emission tomography (PET) with carbon-11 methionine, computed tomography (CT), and magnetic resonance (MR) imaging were performed in 10 patients with histologically verified central nervous system (CNS) lymphoma before and after radiation therapy to compare the radiologic findings and to evaluate the usefulness of PET in monitoring tumor response to radiation therapy. Methionine PET clearly depicted CNS lymphoma before radiation therapy as an increased accumulation of C-11 methionine. The extent of increased accumulation of the radiotracer in tumor tissue markedly decreased after radiation therapy. The area of increased uptake was larger than the enhancing lesions on CT or MR images in most cases. One patient was confirmed to have tumor recurrence at the region of residual increased accumulation on methionine PET images. Methionine PET is useful for the delineation of CNS lymphoma and for monitoring the therapeutic effect of irradiation.

Aged

Comparison of carbon dioxide responsiveness of cerebellar blood flow between affected and unaffected sides with crossed cerebellar diaschisis.

BACKGROUND AND PURPOSE: Concerning vasoreactivity of cerebellar blood flow (CeBF) in patients affected with crossed cerebellar diaschisis (CCD), several controversies have been reported. One is reduced asymmetry of CeBF after acetazolamide administration in 99mTc hexamethylpropyleneamine oxime single-photon emission-computed tomography, and the other is persistent asymmetry with alternation in PaCO2 using the 133Xe clearance method. The purpose of this study is to examine whether CeBF vasoreactivity in the side affected with CCD is the same as that in the unaffected side. METHODS: We analyzed CeBF during hypocapnia, normocapnia, and hypercapnia performed in 27 patients with cerebrovascular disease (age range, 38 to 73 years; mean age, 62.0 +/- 8.5 years) affected by CCD. CeBF was measured using H2(15)O and positron emission tomography. RESULTS: The CeBF ratio of CCD-affected side to CCD-unaffected side was consistent during the perturbation of PaCO2. This ratio was 0.82 +/- 0.08 for PaCO2 elevation and 0.83 +/- 0.07 for PaCO2 lowering. Both were not significantly different from unity. CONCLUSIONS: The percent change of CeBF per millimeter of mercury PaCO2 change was uniform across affected and unaffected sides with CCD. These findings are consistent with our recent findings observed in activated cerebral tissue during photic stimulation.

Adult

[Circulation time determined by carotid angiography in patients with chronic internal carotid artery occlusion: comparison with cerebral blood flow and oxygen metabolism measured by PET].

The degree of collateral circulation in patients with unilaterally chronic internal carotid artery occlusion was estimated by mean transit time of contrast material in rapid sequence carotid angiography (Angiographic MTT), and compared with cerebral blood flow and oxygen metabolism measured by PET. In normal density region on X-ray CT, a significant negative correlation was observed between Angiographic MTT and cerebral blood flow (CBF). This indicates that cerebral blood flow can be estimated by Angiographic MTT. It has been reported that the ratio of cerebral blood volume (CBV) to CBF (CBV/CBF), i.e., mean transit time determined by PET well agreed with OEF, and is good indicator for brain circulation reserve. In this study, no significant correlation was observed between Angiographic MTT and CBV/CBF. However, a significant positive correlation was observed between Angiographic MTT and oxygen extraction fraction (OEF), and no significant correlation was observed between Angiographic MTT and oxygen consumption rate (CMRO2). These indicates that Angiographic MTT may be indicator for brain circulation reserve.

Aged