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. 2020 Nov 9;15(11):e0241987.
doi: 10.1371/journal.pone.0241987. eCollection 2020.

Investigation of the new non-invasive semi-quantitative method of 123I-IMP pediatric cerebral perfusion SPECT

Yasuharu Wakabayashi  1   2 , Mayuki Uchiyama  3 , Hiromitsu Daisaki  2 , Makoto Matsumoto  1 , Masafumi Sakamoto  4 , Kenichi Kashikura  2
Affiliations

Investigation of the new non-invasive semi-quantitative method of 123I-IMP pediatric cerebral perfusion SPECT

Yasuharu Wakabayashi et al. PLoS One. .

Erratum in

Abstract

In pediatric cases requiring quantification of cerebral blood flow (CBF) using 123I-N-isopropyl-p-iodoamphetamine (123I-IMP) single-photon emission computed tomography (SPECT), arterial blood sampling is sometimes impossible due to issues such as movement, crying, or body motion. If arterial blood sampling fails, quantitative diagnostic assessment becomes impossible despite radiation exposure. We devised a new easy non-invasive microsphere (e-NIMS) method using whole-body scan data. This method can be used in conjunction with autoradiography (ARG) and can provide supportive data for invasive CBF quantification. In this study, we examined the usefulness of e-NIMS for pediatric cerebral perfusion semi-quantitative SPECT and compared it with the invasive ARG. The e-NIMS estimates cardiac output (CO) using whole-body acquisition data after 123I-IMP injection and the body surface area from calculation formula. A whole-body scan was performed 5 minutes after the 123I-IMP injection and CO was estimated by region of interest (ROI) counts measured for the whole body, lungs, and brain using the whole-body anterior image. The mean CBF (mCBF) was compared with that acquired via ARG in 115 pediatric patients with suspected cerebrovascular disorders (age 0-15 years). Although the mCBF estimated by the e-NIMS indicated a slight deviation in the extremely low- or high-mCBF cases when compared with the values acquired using the invasive ARG, there was a good correlation between the two methods (r = 0.799; p < 0.001). There were no significant differences in the mCBF values based on physical features, such as patients' height, weight, and age. Our findings suggest that 123I-IMP brain perfusion SPECT with e-NIMS is the simplest semi-quantitative method that can provide supportive data for invasive CBF quantification. This method may be useful, especially in pediatric brain perfusion SPECT, when blood sampling or identifying pulmonary arteries for CO estimation using the graph plot method is difficult.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig 1
Fig 1. Timeline of the protocols, including the whole-body fractional uptake and autoradiography.
Fig 2
Fig 2. Representative image for setting the region of interest with accumulation count for each ROI setting.
a) ROI count for the whole-body (WB). b) ROI count for the lung in the WB scan image. c) ROI count for the brain in the WB scan image. d) ROI count for the brain in single-photon emission computed tomography image. ROI, region of interest.
Fig 3
Fig 3. Mean cerebral blood flow values obtained using whole-body fractional uptake and autoradiography.
a, b) mCBF distribution by height. c, d) mCBF distribution by weight. e, f) mCBF distribution by age.
Fig 4
Fig 4. Comparison of mean cerebral blood flow values obtained by easy-noninvasive micro sphere and autoradiography.
Fig 5
Fig 5. Bland-Altman plot for comparison of easy non-invasive micro sphere and autoradiography.
Small dashed line denotes the limits of agreement (± 1.96 SD).
See this image and copyright information in PMC

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