(Circulation. 1996;94:792-807.)
© 1996 American Heart Association, Inc.
Articles |
Noninvasive Quantification of Regional Myocardial Metabolic Rate for Oxygen by Use of 15O2 Inhalation and Positron Emission Tomography
Theory, Error Analysis, and Application in Humans
MRC Cyclotron and Cardiovascular Research Units, Hammersmith Hospital, London, UK.
Correspondence to Hidehiro Iida, DSc, Department of Radiology and Nuclear Medicine, Research Institute for Brain and Blood Vessels, 6-10 Senshu-Kubota-Machi, Akita City, Akita 010, Japan.
Background A method has been developed to measure the regional myocardial metabolic rate of oxygen consumption (rMMRO2) and oxygen extraction fraction (rOEF) quantitatively and noninvasively in humans by use of 15O2 inhalation and positron emission tomography. This article describes the theory, an error analysis of the technique, and procedures of the method used in a human feasibility study.
Methods and Results Inhaled 15O2 is transported to peripheral tissues, where it is converted to 15O-labeled water of metabolism, which exchanges with the relatively large extravascular tissue space. Quantification of this buildup of radioactivity allows the calculation of rMMRO2 and rOEF. However, a correction for the spillover of the pulmonary gas radioactivity signal into myocardial regions is required and has been made by use of a gas volume distribution estimated from the transmission scan. This was validated by comparative measurements using the inert gas [11C]CH4 in four greyhounds. Spillover of the cardiac chamber radioactivity has been corrected for with an inhaled [15O]CO (blood volume) scan. The underestimation of myocardial radioactivity due to wall motion and thickness has been corrected for by use of values of tissue fraction obtained from the flow measurement [15O](CO2 scan). Values of rOEF were similar (within 4%) whether obtained from gas volume measurements determined from the transmission or [11C]CH4 scan data. 15O2 scan information from six healthy volunteers showed a clear distribution of myocardial radioactivity after the vascular and pulmonary gas 15O background was subtracted. Subsequent compartmental analysis resulted in values for rOEF and rMMRO2 of 0.60±0.11 and 0.10±0.03 mL·min-1·g-1 in the human myocardium at rest.
Conclusions The results of this study are in good agreement with established values. This is the first known approach to allow the direct quantitative determination of rOEF and oxygen metabolism to be made noninvasively on a regional basis.
Key Words: myocardium • oxygen • blood flow • tomography
This article has been cited by other articles:
 |
|
 |
|
  P. Knaapen, T. Germans, J. Knuuti, W. J. Paulus, P. A. Dijkmans, C. P. Allaart, A. A. Lammertsma, and F. C. Visser Myocardial Energetics and Efficiency: Current Status of the Noninvasive Approach Circulation, February 20, 2007; 115(7): 918 - 927. [Full Text] [PDF]
|
|
|
|
 |
|
 I. Serganova, J. Humm, C. Ling, and R. Blasberg Tumor hypoxia imaging. Clin. Cancer Res., September 15, 2006; 12(18): 5260 - 5264. [Full Text] [PDF]
|
|
|
|
 |
|
 R. C. Brunken, J. K. Perloff, J. Czernin, R. Campisi, S. Purcell, P. D. Miner, J. S. Child, and H. R. Schelbert Myocardial perfusion reserve in adults with cyanotic congenital heart disease Am J Physiol Heart Circ Physiol, November 1, 2005; 289(5): H1798 - H1806. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Katoh, K. Morita, T. Shiga, N. Kubo, K. Nakada, and N. Tamaki Improvement of Algorithm for Quantification of Regional Myocardial Blood Flow Using 15O-Water with PET J. Nucl. Med., November 1, 2004; 45(11): 1908 - 1916. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Mizuno, Y. Kimura, T. Iwakawa, K. Oda, K. Ishii, K. Ishiwata, Y. Nakamura, and I. Muraoka Regional differences in blood flow and oxygen consumption in resting muscle and their relationship during recovery from exhaustive exercise J Appl Physiol, December 1, 2003; 95(6): 2204 - 2210. [Abstract] [Full Text]
|
|
|
|
 |
|
 R. J. Gropler Noninvasive measurements of myocardial oxygen consumption--can we do better? J. Am. Coll. Cardiol., February 5, 2003; 41(3): 468 - 470. [Full Text] [PDF]
|
|
|
|
|
|
H. Iida, Y. Tamura, K. Kitamura, P. M. Bloomfield, S. Eberl, and Y. Ono Histochemical Correlates of 15O-Water-Perfusable Tissue Fraction in Experimental Canine Studies of Old Myocardial Infarction J. Nucl. Med., October 1, 2000; 41(10): 1737 - 1745. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Laine, C. Katoh, M. Luotolahti, H. Yki-Jarvinen, I. Kantola, A. Jula, T. O. Takala, U. Ruotsalainen, H. Iida, M. Haaparanta, et al. Myocardial Oxygen Consumption Is Unchanged but Efficiency Is Reduced in Patients With Essential Hypertension and Left Ventricular Hypertrophy Circulation, December 14, 1999; 100(24): 2425 - 2430. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. O. Takala, P. Nuutila, C. Katoh, M. Luotolahti, J. Bergman, M. Maki, V. Oikonen, U. Ruotsalainen, T. Gronroos, M. Haaparanta, et al. Myocardial blood flow, oxygen consumption, and fatty acid uptake in endurance athletes during insulin stimulation Am J Physiol Endocrinol Metab, October 1, 1999; 277(4): E585 - E590. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. O. Takala, P. Nuutila, J. Knuuti, M. Luotolahti, and H. Yki-Jarvinen Insulin action on heart and skeletal muscle glucose uptake in weight lifters and endurance athletes Am J Physiol Endocrinol Metab, April 1, 1999; 276(4): E706 - E711. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Yamamoto, R. de Silva, C. G. Rhodes, H. Iida, A. A. Lammertsma, T. Jones, and A. Maseri Noninvasive Quantification of Regional Myocardial Metabolic Rate of Oxygen by 15O2 Inhalation and Positron Emission Tomography: Experimental Validation Circulation, August 15, 1996; 94(4): 808 - 816. [Abstract] [Full Text]
|
|