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. 2024 Oct 16;14(1):97.
doi: 10.1186/s13550-024-01160-z.

Appearance time of blood in the brain as a possible indicator of oxygen extraction fraction: a feasibility study

Mitsumasa Murao  1 , Nobuyuki Kudomi  2 , Katsuya Mitamura  1 , Takashi Norikane  1 , Yuri Manabe  1 , Yukito Maeda  3 , Yuka Yamamoto  4 , Tetsuhiro Hatakeyama  5 , Yoshihiro Nishiyama  1
Affiliations

Appearance time of blood in the brain as a possible indicator of oxygen extraction fraction: a feasibility study

Mitsumasa Murao et al. EJNMMI Res. .

Abstract

Background: Imaging examination of cerebral blood flow (CBF), oxygen extraction fraction (OEF), and metabolic rate of oxygen is crucial for understanding the normal functioning and pathophysiology of the brain. A recently developed method estimates the appearance time of cerebral blood (ATB) pixel-wise from the imaging examination of CBF alone. In this study, we aimed to test the potential of ATB as an indicator of OEF.

Results: We retrospectively reviewed patients (n = 62) with suspected cerebrovascular disorders including steno-occlusive disease who underwent positron emission tomography (PET) with 15O-labelled tracers. Regarding the generated OEF and ATB images, a visual assessment was performed to test the consistency of the elevated OEF and delayed ATB. The OEF and ATB values and the absolute differences between their ipsilateral and contralateral sides were extracted and obtained for the entire hemisphere and the middle, anterior, and posterior cerebral arterial regions. Consistency was observed in 52 PET scans (83.9%) in visual assessment. The OEF and ATB values were moderately correlated (r = 0.553, p < 0.001), and the differences between their ipsilateral and contralateral sides were weakly correlated (r = 0.276, p < 0.001).

Conclusion: Our results indicate the potential of ATB as an indicator of OEF.

Keywords: 15O-labelled tracer; Appearance time of blood; Cerebral blood flow; Oxygen extraction fraction; Positron emission tomography.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Representative ROIs on normalized image for ACA (green), MCA (yellow) and PCA (red)
Fig. 2
Fig. 2
PET images of a 41-year-old woman with no stenosis in the carotid or brain arteries in Group A. The CBF image shows no decrease (a). The OEF image shows no elevation (b). The ATB image shows no delay (c)
Fig. 3
Fig. 3
PET images of a 78-year-old man with stenosis in the bilateral common carotid arteries in Group B. The CBF image shows a decrease on the left side (a). The OEF image shows no elevation (b). The ATB image shows a delay on the left side (c). During antiplatelet therapy, the patient underwent a second PET scan due to stroke symptoms and was classified into Group C. The CBF image shows a decrease on the left side (d). The OEF image shows elevation on the left side (e). The ATB image shows a delay on the left side (f). The third PET scan was performed after stenting for the left common carotid artery, and the patient was classified into Group A. The CBF image shows a decrease on the left side (g). The OEF image shows no elevation (h). The ATB image shows no delay (i)
Fig. 4
Fig. 4
PET images of a 75-year-old man with stenosis in the left internal carotid artery in Group C. The CBF image shows a decrease on the left side (a). The OEF image shows elevation on the left side (b). The ATB image shows a delay on the left side (c)
Fig. 5
Fig. 5
PET images of a 77-year-old man with occlusion of the right internal carotid artery in Group D. The CBF image shows a decrease on the right side (a). The OEF image shows elevation on the right side (b). The ATB image shows no delay (c)
Fig. 6
Fig. 6
Relationship between OEF and ATB values (a), indicating moderate correlation (r = 0.553, p < 0.001), and between ΔOEF and ΔATB (b), indicating weak correlation (r = 0.276, p < 0.001)
Fig. 7
Fig. 7
Relationships between group classifications based on visual assessment of ΔOEF (a) and ΔATB (b) images of the hemisphere. Box plots show the median, 25th percentile, and 75th percentile of data, with the minimum and maximum values represented by whiskers
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