Pharmacokinetics of positron-labeled 1,3-bis(2-chloroethyl)nitrosourea in human brain tumors using positron emission tomography.

The nitrosoureas are widely used in the chemotherapy of brain tumors, two of the most common being 1,3-bis(2-chloroethyl)nitrosourea and 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea. However, we do not understand how these compounds work, nor do we know which part of the molecule has antitumor activity. In six patients with brain tumor, we measured the kinetic behavior of positron-labeled 1,3-bis(2-chloroethyl)nitrosourea in both the tumor and the normal brain with the aid of positron emission tomography; we also analyzed the distribution of radioactivity in plasma. We found the clearance of total radioactivity from the tumor to be significantly slower than from the contralateral brain and plasma, indicating a different rate of 1,3-bis(2-chloroethyl)nitrosourea decomposition in the tumor than in normal brain.

The transfer coefficients for L-valine and the rate of incorporation of L-[1-14C] valine into proteins in normal adult rat brain.

An autoradiographic method for the measurement of the rate of valine incorporation into brain proteins is described. The transfer coefficients for valine into and out of the brain and the rate of valine incorporation into normal rat brain proteins are given. The valine incorporation and the transfer constants of valine between different biological compartments are provided for 14 gray matter and 2 white matter structures of an adult rat brain. The rate of valine incorporation varies between 0.52 +/- 0.19 nmol/g/min in white matter and 1.94 +/- 0.47 in inferior colliculus (gray matter). Generally, the rate of valine incorporation is about three to four times higher in the gray matter than in the white matter structures.

The deoxyglucose method in the ferret brain. II. Glucose utilization images and normal values.

To measure cerebral glucose utilization with the autoradiographic deoxyglucose method, the tracer transfer rate constants and lumped constants must be known. 2-Deoxyglucose (2-DG) and fluorodeoxyglucose (FDG) constants were determined in 18 gray and white matter brain structures of the anesthetized ferret. The ferret is a domestic carnivore particularly suitable for deoxyglucose studies because of its small brain size and low body weight. The average gray matter rate constants for tracer transfer across the blood-brain barrier are similar for 2-DG and FDG in the ferret brain (K*1 = 0.21 ml/g/min and k*2 = 0.39 min-1). The rate constant for the rate-limiting step of tracer phosphorylation, k*3, is 1.6 times higher for FDG than for 2-DG (0.21 vs. 0.13 min-1). Loss of metabolized tracer is about 1-1.5%/min throughout the ferret brain for both tracers as estimated for a 180 min experimental period. Taking into account this loss, the lumped constant is 0.92 for FDG and 0.68 for 2-DG. Glucose utilization values in the brain of the anesthesized ferret range from 33 mumol/100 g/min in the corpus callosum to 104 mumol/100 g/min in the caudate nucleus. Representative glucose utilization images of coronal sections of the ferret brain are shown. Brain structures are identified on the same slices counterstained with thionin.

Quantitative measurements of regional glucose utilization and rate of valine incorporation into proteins by double-tracer autoradiography in the rat brain tumor model.

We examined the rate of glucose utilization and the rate of valine incorporation into proteins using 2-[18F]fluoro-2-deoxyglucose and L-[1-14C]-valine in a rat brain tumor model by quantitative double-tracer autoradiography. We found that in the implanted tumor the rate of valine incorporation into proteins was about 22 times and the rate of glucose utilization was about 1.5 times that in the contralateral cortex. (In the ipsilateral cortex, the tumor had a profound effect on glucose utilization but no effect on the rate of valine incorporation into proteins.) Our findings suggest that it is more useful to measure protein synthesis than glucose utilization to assess the effectiveness of antitumor agents and their toxicity to normal brain tissue. We compared two methods to estimate the rate of valine incorporation: "kinetic" (quantitation done using an operational equation and the average brain rate coefficients) and "washed slices" (unbound labeled valine removed by washing brain slices in 10% trichloroacetic acid). The results were the same using either method. It would seem that the kinetic method can thus be used for quantitative measurement of protein synthesis in brain tumors and normal brain tissue using [11C]-valine with positron emission tomography.

Influence of the input function on the calculation of the local cerebral metabolic rate for glucose in the deoxyglucose method.

We describe here a modification of Sokoloff's deoxyglucose method which requires fewer blood samples but does not diminish accuracy. To calculate the local cerebral metabolism for glucose (LCMRglu), the input function containing the initial peak must be known. This requires many blood samples for accurate definition. To estimate the influence of the peak on the LCMRglu, a dummy input function was generated by extrapolating the data points after 2 min back to 0 min. Next, a biexponential curve, fitted to a reduced number of samples, was applied for the input function. The error introduced into the LCMRglu by using these different approximations was analyzed with an error function derived from an operational equation. The results indicate that the error of LCMRglu caused by neglecting the peak is less than 3%. Furthermore, the error of LCMRglu resulting from use of the biexponential approximation is a function of LCMRglu: the error decreases as the LCMRglu increases and remains at less than 3% even when only seven data points are used (half the usual number of the standard method). Finally, the LCMRglu was calculated by the biexponential curve-fitting, using the experimental data, and compared with that calculated by Sokoloff's computer program. Both methods were in good agreement. This modified method offers great advantage for simultaneous measurement of CMRglu, CBF, and other physiological parameters by means of the multiple tracer autoradiographic technique in the small laboratory animal.

Evaluation of [18F]-4-fluoroantipyrine as a new blood flow tracer for multiradionuclide autoradiography.

This article reports the evaluation of [18F]-4- fluoroantipyrine (FAP) as a quantitative blood flow tracer by comparing blood flow measured with [18F]FAP to that determined simultaneously with [14C]-4-iodoantipyrine (IAP), a standard blood flow tracer, by means of double-tracer autoradiography. The single-pass extraction value (m), which indicates diffusibility of a tracer, was determined according to the procedure described by Crone . The diffusibility of FAP was essentially the same as that of IAP. The brain-blood partition coefficient for FAP was found to be similar to that for IAP, 0.89 +/- 0.01. Values of local cerebral blood flow obtained with FAP agree with those determined with IAP. From these results, we concluded that FAP is indeed as good a blood flow tracer as IAP. Since 18F is a positron-emitting radionuclide, it might be a useful tracer for blood flow measurement by positron emission tomography.

A new method to measure brain serotonin synthesis in vivo. I. Theory and basic data for a biological model.

We describe here an autoradiographic method to measure the in vivo rate of serotonin synthesis in rat brain. The method is based on the use of the L-tryptophan analogue alpha-methyl-L-tryptophan (alpha-MTrp), which is converted in vivo into alpha-methylserotonin (alpha-M5HT). Since alpha-M5HT is not a substrate for monoamine oxidase, it is accumulated in the brain tissue. Data are presented to confirm time-dependent conversion of alpha-MTrp into alpha-M5HT in the dorsal raphe nucleus and also in the pineal body, an organ outside the blood-brain barrier. It has also been shown that washing brain slices in 10% trichloroacetic acid results in less than 3% incorporation of alpha-MTrp into brain proteins. The rates of synthesis are calculated in several grossly dissected brain structures by using tracer kinetics and a three-compartment biological model. The half-life of the precursor pool is estimated to be approximately 20 min. The rate of serotonin synthesis is highest in the pineal body.

Quantification of glucose utilization in an experimental brain tumor model by the deoxyglucose method.

Reevaluation of lumped and rate constants is necessary when Sokoloff's 2-deoxyglucose (DG) method is used to measure glucose utilization in pathological tissue. We describe here a modification of Sokoloff's lumped constant measurement that permits simultaneous estimation of both lumped and rate constants from a single animal experiment. A subcutaneous tumor model (AA ascites tumor) was used for measurement of these constants with a procedure similar to Sokoloff's that kept the plasma tracer concentration constant. Measured constants were as follows: lumped constant, 0.654 +/- 0.081; k1, 0.196 +/- 0.038 min-1; k2, 0.262 +/- 0.067 min-1; k3, 0.117 +/- 0.044 min-1. These constants were used to quantify glucose utilization in the implanted brain tumor. To test the validity of this method, we compared a fraction of the free DG pool calculated using the tumor constants with a fraction measured directly by chromatographic analysis of tissue samples from both subcutaneous tumor and implanted brain tumor. The values derived by chemical analysis agreed well with those predicted by the calculations. The value of k4 varied from 0.0031 +/- 0.0018 min-1 for the tumor tissue to 0.0214 +/- 0.0024 min-1 for tumors with a large necrotic center. This method would be especially useful when applied to xenograft human gliomas in nude mice for quantification of glucose utilization in human gliomas by means of positron emission tomography.

Time-dependent changes of lumped and rate constants in the deoxyglucose method in experimental cerebral ischemia.

Time-dependent changes in the lumped and rate constants in a bilateral middle cerebral artery (MCA) occlusion in cats were evaluated. These variables were measured in 11 cats after a sham operation, in five after a 1-h occlusion, in two after a 2-h occlusion, in five after a 4-h occlusion, and in four after a 16-h occlusion. The time course of the cerebral tissue radioactivity [Ci* (t)] was monitored by external coincidence counting during a programmed infusion of [18F]2-fluorodeoxyglucose (FDG). Arterial plasma concentration [Cp* (t)] of tracer was kept constant during the first 45 min. Comparison of k2* and k3* in the sham-operated group, estimated by external coincidence counting, and by the ratio of extraction fractions of glucose and [18F]2-FDG, demonstrated no significant difference between these rate constants in these two groups of animals. The rate and lumped constants were also estimated from Ci* (t) and Cp* (t), as well as from the ratio of extraction fractions of glucose and [18F]2-FDG, respectively, in the MCA occlusion group. Significant decrease in k3* was observed after 1 h of occlusion (20% lower than in the sham operation, p less than 0.05); in k1* decrease occurred within 4 h of occlusion (21% lower than in the sham operation, p less than 0.05). However, decrease in k2* was observed only after 16 h of occlusion (26% lower than in the sham operation, p less than 0.05). Namely, decrease of rate constants occurred first in k3* then in k1* and k2*.(ABSTRACT TRUNCATED AT 250 WORDS)

A new method to measure brain serotonin synthesis in vivo. II. A practical autoradiographic method tested in normal and lithium-treated rats.

We describe here a practical autoradiographic method to estimate the rate of serotonin synthesis in brain. A two-time point method (60 and 150 min after injection of alpha-[14C]methyl-L-tryptophan) was first evaluated in 14 normal rats (7 at each time point). After this the method was tested in lithium-treated rats. In normal rats the rate of serotonin synthesis measured by the two-time point method generally correlated with known concentrations of tryptophan hydroxylase. The rate of synthesis in lithium-treated rats was compared with that in sham-treated rats (NaCl treatment). The results showed a significant increase in the synthesis rate in some cerebral structures. The greatest increases in the serotonin synthesis rate, attributable to the lithium treatment, were observed in the parietal cortex (52%) and caudate nucleus (47%). This is the first investigation to demonstrate, with autoradiographic resolution (approximately 100 microns), the differential changes in the rate of serotonin synthesis in the brain. Lithium had no significant effect on the rate of synthesis in the pineal gland.

Effect of vascular activity in the determination of rate constants for the uptake of 18F-labeled 2-fluoro-2-deoxy-D-glucose: error analysis and normal values in older subjects.

Regional cerebral blood volume (CBV) can be calculated using data obtained during the kinetic analysis of 18F-labeled 2-fluoro-2-deoxy-D-glucose (FDG) uptake measured by positron emission tomography (PET). As a result the influence of vascular activity upon the determination of FDG rate constants can be minimized. The method is investigated by simulation experiments and by analysis of PET studies on seven older, healthy human volunteers aged 52-70 years. The accuracy of measured FDG rate constants k1, k2, and k3, obtained either by omitting the early portion of the uptake curve or by explicit inclusion of CBV as a fit parameter, is compared. The root mean square error in measured rate constant for the latter method is equivalent to that obtained by omitting the first 2.5-3 min of tissue data and neglecting the CBV term. Hence, added information about the physiological state of the tissue is obtained without compromising the accuracy of the (FDG) rate constant measurement. In hyperemic tissue the explicit determination of the vascular fraction results in more accurate estimates of the FDG rate constants. The ratio of CBV determined by this method to CBV obtained using C15O in six subjects with CBV in the normal range was 0.92 +/- 0.32. A comparison of the CBV image obtained by this method with that obtained using C15O in an arteriovenous malformation case demonstrates the accuracy of the approach over a wide range of CBV values. The mean value for CBV fraction in gray matter obtained by this method in the older control group was 0.040 +/- 0.014. Average gray matter rate constants obtained were k1 = 0.084 +/- 0.012, k2 = 0.150 +/- 0.071, and k3 = 0.099 +/- 0.045 min-1.

An improved approach for measurement of regional cerebral rate constants in the deoxyglucose method with positron emission tomography.

A new experimental approach was designed to measure regional rate constants for [18F]2-fluoro-2-D-deoxyglucose in the three-compartment model. A programmed infusion was used to keep the plasma tracer concentration constant for the first 20 min. Positron emission tomography images of the brain were taken every minute for 20 min in a low-resolution mode, then every 15-20 min for 2-3 h in a medium-resolution mode. Two simplified operational equations for the calculation of the regional rate constants were derived that incorporated the contribution of the vascular compartment to tissue activity. The first equation was applied to data collected during the initial 20 min (when the concentration of plasma tracer was constant) to estimate the values of k1*, k2*, k3*, and the fraction of the vascular compartment. The second equation was applied to data collected during the whole experimental period to find the value of k4* and to provide a better estimate of k3*. The regional rate constants measured experimentally in three dogs and a brain tumor patient agreed well with those in the literature. This method permits estimation of the local CMRglu under pathological conditions using regionally measured rate constants and provides new information on the pathophysiological meaning of the rate constants.

In vivo measurement of [18F]fluorodeoxyglucose rate constants in rat brain by external coincidence counting.

The operational equation for the double-label deoxyglucose method described in the following paper requires the knowledge of the rate constants for transfer of fluorodeoxyglucose across the blood-brain barrier (K1* and K2*), and those for phosphorylation of fluorodeoxyglucose (K3*) and dephosphorylation of fluorodeoxyglucose-6-phosphate (k4*). These rate constants were determined in anesthetized rats by external coincidence counting. Radioactivity in parietal brain was measured for a 110 min experimental period after a bolus injection of 18F-labeled fluorodeoxyglucose. Apparent rate constants were obtained by fitting the resulting tissue radioactivity curves to the tissue radioactivity function of the deoxyglucose model modified to take into account the dephosphorylation of fluorodeoxyglucose-6-phosphate. The apparent fluorodeoxyglucose rate constants in rat brain are K1* = 0.195 ml g-1 min-1, k2* = 0.379 min-1, k3* = 0.088 min-1, and k4* = 0.009 min-1.

Double-label autoradiographic deoxyglucose method for sequential measurement of regional cerebral glucose utilization.

A new double-label autoradiographic glucose analog method for the sequential measurement of altered regional cerebral metabolic rates for glucose in the same animal is presented. This method is based on the sequential injection of two boluses of glucose tracer labeled with two different isotopes (short-lived 18F and long-lived 3H, respectively). An operational equation is derived which allows the determination of glucose utilization for the time period before the injection of the second tracer; this equation corrects for accumulation and loss of the first tracer from the metabolic pool occurring after the injection of the second tracer. An error analysis of this operational equation is performed. The double-label deoxyglucose method is validated in the primary somatosensory ("barrel") cortex of the anesthetized rat. Two different rows of whiskers were stimulated sequentially in each rat; the two periods of stimulation were each preceded by an injection of glucose tracer. After decapitation, dried brain slices were first exposed, in direct contact, to standard X-ray film and then to uncoated, "tritium-sensitive" film. Results show that the double-label deoxyglucose method proposed in this paper allows the quantification and complete separation of glucose utilization patterns elicited by two different stimulations sequentially applied in the same animal. The double-label deoxyglucose is of potential usefulness in sensory physiology since it makes possible the separate mapping of regional cerebral glucose utilization patterns elicited by two sequentially applied sensory stimulations in the same animal. The method allows the quantification of a step-like change in regional cerebral glucose utilization in the same animal. It could be used to study the cerebral metabolic effects induced by neuropharmacological agents or surgical interventions applied during the experiment. Using each animal as its own control eliminates intersubject variability. Thus experimental cost and effort can be saved, and the reliability of the results obtained can be increased.

The requirement for constant arterial radioactivity in the C15O2 steady-state blood-flow model.

This study evaluates the discrepancy between the true CBF value and the CBF value calculated according to the C15O2 steady-state model, for situations where the arterial input function, Ca(t), deviates considerably from its steady-state value, Ca. The fact that arterial input function and tissue O-15 concentration are not independent variables is taken into account. Inconstant or variable arterial input functions are simulated and the corresponding tissue O-15 concentrations calculated. The steady-state CBF values are evaluated for several temporal variations of Ca over the period of imaging, all derived from Ca(t) by simulation of various blood-sampling schemes, and are compared with the true CBF value. The study indicates that reliable CBF values are obtained by the C15O2 steady-state method even under severely impaired "unsteady-state" conditions, provided that either the true average arterial concentration over the entire scan, or the average concentration from multiple arterial samples, is used.

An on-line synthesis of [15O]N2O: new blood-flow tracer for PET imaging.

This paper describes a recently developed on-line synthesis of a new blood-flow tracer, O-15-labeled nitrous oxide. The tracer was produced by catalytic oxidation of anhydrous ammonia in a gas mixture containing O-15-labeled molecular oxygen. (The oxygen-15 was produced by a 14N(d,n)15O reaction.) Anhydrous ammonia was mixed with the gas containing [15O]O2, and after preheating to about 200 degrees C was carried through an oven containing a Pt catalyst kept at about 310 degrees C. Labeled gas was purified in H3PO4 and KOH traps. O-15-labeled nitrous oxide was identified by gas radiochromatography and by various chemical reactions. Radiochemical purity of the O-15-labeled nitrous oxide exceeded 98%, radiochemical yield corrected for radioactioactive decay was 15-20%, and specific activity at the end of synthesis was about 50 mCi/mmole.

Metabolic and hemodynamic evaluation of gliomas using positron emission tomography.

Positron emission tomography (PET) was used on 16 patients with untreated cerebral gliomas to measure cerebral glucose and oxygen metabolism, oxygen extraction, blood flow, and blood volume. In addition, pH values were obtained for seven cases. Gliomas were later proven by biopsy; two patients had tumors with degrees of malignancy of grade II, two patients had grade III, and 12 patients had grade IV tumors. Compared with homologous gray matter regions in the opposite hemisphere, tumor tissue showed increased blood volume, but decreased oxygen extraction and oxygen metabolism. Compared with grade II tumors, grade IV tumors demonstrated higher blood volumes, but lower relative oxygen extraction and utilization. Tumor blood flow was variable, but was lower in the higher grade tumors. Rates of glucose utilization in tumor, calculated by using individually determined rate constants, were variable, and did not correlate with tumor size or tumor grade. Parietal tumors (n = 6) tended to have higher relative glucose utilization and blood flow, and lower relative oxygen extraction, when compared with frontal tumors (n = 4). Tumor pH differed significantly from the pH in contralateral brain (p less than 0.005); alkalotic pH values were consistently seen. These findings in and around cerebral gliomas studied before intervention differ from the results found in gliomas after exposure to radiation or chemotherapy.

Alternative approach to estimate lumped constant in the deoxyglucose model: simulation and validation.

An alternative method of estimating the lumped constant (LC) in the deoxyglucose model was developed. The LC was estimated using data obtained during the first 10 min after injection of the tracer by a nonlinear least-squares (NLSQ) method. The method does not require a constant plasma concentration. This approach was evaluated in a computer simulation by adding different levels of noise and considering various input functions. Errors in the estimated LC in this and Sokoloff et al.'s conventional method were compared. We found that the approach proposed here results in more reliable estimates of LC. The study in completed in a shorter experimental period, and any shape of the input function can be used. The new technique was then applied to measure whole brain LC and rate constants in cat brain for 2-[18F]fluoro-2-deoxy-D-glucose (2-[18F]FDG). Measured mean value (+/-s.e.m.) for the whole brain LC = 0.443 +/- 0.012 (N = 7), for the whole brain k2* = 0.124 +/- 0.009 and k3* = 0.024 +/- 0.001 (N = 7).

Stability of regional cerebral glucose metabolism in the normal brain measured by positron emission tomography.

Cerebral glucose utilization (LCMRGI) was measured using the [18F]fluorodeoxyglucose method with PET in two groups of ten healthy young volunteers, each scanned in a resting state under different methodological conditions. In addition, five subjects had a second scan within 48 hr. Mean hemispheric values averaged 45.8 +/- 3.3 mumol/100 g/min in the right cerebral hemisphere and 47.0 +/- 3.7 mumol/100 g/min in the left hemisphere. A four-way analysis of variance (group, sex, region, hemisphere) was carried out on the results using three different methods of data manipulation: (a) the raw values of glucose utilization, (b) LCMRGI values "normalized" by the mean hemispheric gray matter LCMRGI value, and (c) log transformed LCMRGI values. For all analysis techniques, significantly higher LCMRGI values were consistently seen in the left mid and posterior temporal area and caudate nucleus relative to the right, and in the right occipital region relative to the left. The coefficient of variation of intrasubject regional differences (9.9%) was significantly smaller than the coefficient of variation for regions between subjects (16.5%). No differences were noted between the sexes and no effect of repeat procedures was seen in subjects having multiple scans. In addition, inter-regional LCMRGI correlations were examined both in values from the 20 normal subjects, as well as in a set of hypothetical "abnormal" values. Results were compared with those reported from other PET centers; despite certain methodological differences, the intersubject and inter-regional variation of LCMRGI is fairly constant.

No-carrier-added carbon-11-labeled sn-1,2- and sn-1,3-diacylglycerols by [11C]propyl ketene method.

This article describes the preparation of sn-1,2-[11C]diacylglycerols and sn-1,3-[11C]diacylglycerols by a no-carrier-added reaction based on a labeling method using [1-11C]propyl ketene, which is one of the most potent acylating agents. [1-11C]Propyl ketene was produced by pyrolytic decomposition of [1-11C]butyric acid and was trapped in pyridine containing L-alpha-palmitoyl-lysophosphatidylcholine, producing L-alpha-palmitoyl-2-[1-11C]butyryl-sn-glycero-3-phosphorylcholine. We adopted an enzymatic reaction to remove the phosphorylcholine, in which L-alpha-palmitoyl-2-[1-11C]butyryl-sn-glycero-3-phosphorylcholine was incubated with phospholipase C, hydrolyzing to produce 1-palmitoyl-sn-2-[1-11C]butyrylglycerol. Total synthesis time was about 50 minutes and the specific activity was estimated at 93 GBq/mumol (2.5 Ci/mumol) at end of synthesis. Radiochemical yield was 3.8% based on the trapped 11CO2. sn-1,3-[11C]Diacylglycerol was also synthesized by [1-11C]propyl ketene reaction with 1-palmitoyl-sn-glycerol in a single procedure. The regional brain tissue radioactivities obtained in sn-1,2-[11C]diacylglycerol were higher than those of sn-1,3-[11C]diacylglycerol, and the regional values varied widely. In autoradiography of brain slices from conscious rats, sn-1,2-[11C]diacylglycerol incorporation sites were discretely localized, especially in the amygdala, cerebral cortex, and hippocampus, suggesting that intensive neuronal processing occurred in these areas on the basis of phosphatidylinositol turnover.