Validation studies for brain blood flow assessment by radioxenon tomography.

A tomographic technique has been used recently for cerebral blood flow measurements with inhaled radioxenon. Based on experiments in a specially developed dynamic phantom and on studies in primates in vivo, we have analyzed the validity of this method for measurements of both regional and total blood flow in the brain. We have also examined the errors introduced into flow computations as a function of changes in such parameters as: rate of xenon input, size of region of interest, magnitude of regional flow rates, and inter-regional flow differences. Our findings indicate a reasonable degree of accuracy for flow measurements in gray matter regions that are 3 cm in diameter or larger, while white matter blood flow is generally overestimated. The accuracy for regional flow assessments degrades as a function of: diminishing region size, increasing inter-regional flow differences, and flow rates in excess of 100 ml/100 g/min. Measurements for brain regions 2 cm or smaller in diameter can be in error by 25-50% as a result of partial volume averaging. Although the technique is not ideal for accurate flow measurements in small regions of the brain, it nevertheless provides a convenient means of assessing perfusion in major vascular territories of the brain in routine clinical applications.