On the uniqueness of cerebral blood flow measured by the in vivo autoradiographic strategy and positron emission tomography.

Factors are examined in this report which govern the uniqueness and sensitivity of regional cerebral blood flow (rCBF), as determined by an in vivo autoradiographic strategy and positron emission tomography (PET), and a series of theorems is derived which specify conditions under which a unique relationship between cumulative cranial activity of the tracer (C) and regional blood flow (f) may be assured. It is demonstrated that, independent of the specific form of the arterial tracer input function, flow is a unique function of C whenever the start time (T1) of the PET scan is coincident with the start of tracer infusion. Other theorems state that, even for nonzero T1S, a unique solution for flow may be expected, as long as the duration of the scan is sufficiently short. The implementation of this theory is illustrated using arterial tracer activity curves obtained in three normal subjects by a multiple arterial sampling procedure following the bolus i.v. infusion of 20-30 microCi of [15O]water. Based on these arterial curves, it is confirmed that the C vs. f relationship resulting from scan parameters T1 = 0 and T2 = 1.5 min (i.e., a PET scan of 90 s commencing with tracer infusion) has an excellent separation of flow values within the range of physiological interest, whereas a 90-s scan beginning at time T1 = 1.7 min results in poorer separation of flow values and loss of the monotonic relationship between C and f at higher flows. The results of this study serve to clarify the in vivo autoradiographic method for measuring rCBF in humans and help to define favorable study parameters for assuring uniqueness and sensitivity of the flow measurement.