Noninvasive quantification of local cerebral metabolic rate of glucose for clinical application using positron emission tomography and 18F-fluoro-2-deoxy-D-glucose.

Until now, input function is still required in quantification of local cerebral metabolic rate of glucose (LCMRGlc) using positron emission tomography (PET) and (18)F-fluoro-2-deoxy-D-glucose (FDG). Some image-derived methods were developed to get input function noninvasively instead of the arterial blood sampling method, but they needed to make complicated corrections manually, so they cannot always be applied in clinic directly. Here, we propose a simple method based on the Patlak approach by using a reference tissue region and without using any information of input function. This simulation study revealed that the present method was in good agreement with Patlak method; the difference between two methods was less than 5%. The statistical errors with two methods were also obtained, and the results showed the accuracy of LCMRGlc estimated with present method was better than that with Patlak method slightly. The simulation results indicated that the calculation of LCMRGlc with present method was quite stable and independent of the choosing of reference tissue region. All of these show that the present method is a good approximation to Patlak method. The calculation with this method is very simple and easy to perform voxel by voxel; therefore, it can be widely used not only in laboratory studies but also in clinical applications although it only provides the relative rates.