Absolute SPECT/CT quantification of cerebral uptake of 99mTc-HMPAO for patients with neurocognitive disorders

Friedrich Welz; James C. Sanders; Torsten Kuwert; Juan Maler; Johannes Kornhuber; Philipp Ritt

doi:10.3413/Nukmed-0765-15-09

Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 2016; 55(04): 158-165
DOI: 10.3413/Nukmed-0765-15-09

Original article

Schattauer GmbH

Absolute SPECT/CT quantification of cerebral uptake of ^99mTc-HMPAO for patients with neurocognitive disorders

Absolute SPECT/CT-Quantifizierung des zerebralen ^99mTc-HMPAO-Uptake bei Patienten mit neuro-kognitiven Erkrankungen

Authors

Friedrich Welz

¹Clinic for Nuclear Medicine, Friedrich-Alexander-University Erlangen-Nürnberg, Germany
James C. Sanders

¹Clinic for Nuclear Medicine, Friedrich-Alexander-University Erlangen-Nürnberg, Germany

²Pattern Recognition Lab, Friedrich-Alexander-University Erlangen-Nürnberg, Germany
Torsten Kuwert

¹Clinic for Nuclear Medicine, Friedrich-Alexander-University Erlangen-Nürnberg, Germany
Juan Maler

³Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, Germany
Johannes Kornhuber

³Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, Germany
Philipp Ritt

¹Clinic for Nuclear Medicine, Friedrich-Alexander-University Erlangen-Nürnberg, Germany

Abstract

Summary

It was reported from planar imaging studies that the cerebral uptake of injected ^99mTc-HMPAO activity is about 4–7% in humans. Recent work has shown that modern SPECT/ CT devices are able to quantify the tissue concentration of radioactivity in vivo in absolute units (Bq/ml), while avoiding the limitations of planar techniques. The aims of this study were (a) to determine the cerebral uptake of ^99mTc-HMPAO in absolute units in SPECT/CT, (b) to investigate potential differences in absolute tracer uptake for patients suspected of dementia. Patients, methods: We performed ^99mTc-HMPAO SPECT/CT in 65 patients with suspected dementia. ^99mTc-HMPAO uptake was determined using a previously published quantitative SPECT/CT protocol. The absolute HMPAO uptake and the results of a regionalized analysis were compared for MMSE and NINCDS-ADRDA based patient groups. Results: The mean absolute uptake of ^99mTc-HMPAO for our patient population was 4.3 ± 0.8% of the injected dose. The uptake, as well as the regionalized analysis yielded significantly different results for low ( 23) and high (>23) MMSE groups and also for some of the NINCDS-ADRDA groups. Conclusion: Our results show that the absolute cerebral uptake of ^99mTc-HMPAO is in the range of previously reported results, obtained by planar techniques. Absolute uptake is significantly different between the patient groups.

Zusammenfassung

Der Gesamtuptake von ^99mTc-HMPAO im menschlichen Gehirn wurde in früheren Studien mithilfe planarer Bildgebung auf ca. 4–7% der injizierten Dosis bestimmt. Kürzlich wurde gezeigt, dass ebenso mit modernen SPECT/CT-Geräten die In-vivo-Aktivitätskonzentration im Gewebe in absoluten Einheiten (Bq/ml) quantifiziert werden kann, bei gleichzeitiger Vermeidung der Limitationen der planaren Bildgebung. Die Ziele dieser Studie waren (a) den absoluten Uptake von ^99mTc-HMPAO mithilfe der SPECT/CT zu bestimmen, sowie (b) mögliche Unterschiede des absoluten Uptakes verschiedener Gruppen von Demenzpatienten zu ermitteln. Patienten, Methoden: In 65 Patienten mit Verdacht auf Demenzerkrankung wurden ^99mTc-HMPAO-SPECT/CT durchgeführt. Der absolute ^99mTc-HMPAO-Uptake wurde auf Basis einer bereits veröffentlichten Methode bestimmt. Darüber hinaus wurden gruppenspezifische HMPAO-Uptakes ermittelt und auf Unterschiede geprüft. Die Gruppeneinteilung erfolgte anhand von MMSE- und NINCDS-ADRDA-Kriterien. Die Ergebnisse wurden denen der Standardmethode, des regionalisierten Vergleichs mit einem Normkollektiv, gegenübergestellt. Ergebnisse: Der mittlere absolute Uptake von ^99mTc-HMPAO war 4,3 ± 0,8% der injizierten Dosis. Sowohl die absolute Quantifizierung, als auch der regionalisierte Vergleich mit dem Normkollektiv führte zu signifikant unterschiedlichen Ergebnissen für Gruppen mit niedrigen ( 23) bzw. hohen (>23) MMSE Werten und ebenso für NINCDS-ADRDA basierte Gruppen. Schlussfolgerung: Unsere Ergebnisse deuten darauf hin, dass der Gesamtuptake von ^99mTc-HMPAO im Gehirn im bisherigen, durch planare Bildgebung bestimmten Bereich ist. Es gibt zwischen den betrachteten Patientengruppen signifikante Unterschiede im Uptake.

Keywords

Absolute quantification - SPECT/CT - HMPAO - brain perfusion

Schlüsselwörter

Absolute Quantifizierung - SPECT/CT - HMPAO - Gehirnperfusion

Full Text

References

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