Abstract
The cerebral and cerebellar distribution of 99mTc-(d,1)-hexamethylpropyleneamine oxime (HM-PAO) was investigated by means of a rotating gamma camera in 12 patients with cerebral glioma. Using the corresponding contralateral region as control, reduced uptake of HM-PAO in the tumor region was demonstrated in 10 of the 12 patients. Reduced blood flow in a brain area remote from a circumscribed lesion reflects reduced activation following the interruption of afferent nervous pathways. Reduced HM-PAO uptake indicative of such diaschisis was demonstrated in the visual cortex contralateral to homonymous hemianopia in the two patients with this deficit. In the three patients with the most marked hemiparesis, the cerebellar hemisphere contralateral to the tumor showed significantly reduced HM-PAO uptake indicative of crossed cerebellar diaschisis. SPECT using commonly available gamma cameras and 99mTc-HM-PAO seems capable of depicting reduced flow in functionally inactivated brain areas, and may be clinically interesting as an alternative to more specialized techniques for the investigation of local cerebral blood flow.
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Andersen A, Holm S, Vorstrup S, Paulson OB, Kristensen K, Lassen NA (1985) Tomographic brain images using a new technetium-99m labeled oxime Pn-26 with excellent brain retention. J Nucl Med 26:827 (Abstr)
Baron JC, Bousser MG, Comar D, Castaigne P (1980) Crossed cerebellar diaschisis in human supratentorial brain infarction. Trans Am Neurol Assoc 105:459–461
Buell U, Moser P, Schmiedek P, Leinsinger G, Kreising T, Kirsch CM, Einhaupl K (1984) Dynamic SPECT with Xe-133: Regional cerebral blood flow in patients with unilateral cerebro-vascular disease: Concise communication. J Nucl Med 25:441–446
Cronqvist S, Ingvar DH, Lassen NA (1965) Quantitative measurements of regional cerebral blood flow related to neuroradiological findings. Acta Radiol (Diagn) 5:760–766
Ell PJ, Hocknell JML, Jarritt Ph (1985) A 99Tcm-labeled radiotracer for the investigation of cerebral vascular disease. Nucl Med Comm 6:437–441
Fukuyama H, Kameyama M, Harada K, Fujimoto N, Kobayashi A, Taki W, Ishikawa T, Handa H, Tanada S, Torizuka K (1986) Thalamic tumors invading the brain stem produce crossed cerebellar diaschisis demonstrated by PET. J Neurol Neurosurg Psychiat 49:524–528
Holmes RA, Chaplin SB, Royston KG (1985) Cerebral uptake and retention of 99Tcm-hexamethypropyleneamine oxime (99Tcm-HM-PAO). Nucl Med Comm 6:443–447
Holmes RA (1986) A reawakening of interest in radionuclide brain imaging. J Nucl Med 27:299–301
Kanaya H, Endo H, Sugiyama T, Kuroda K (1983) “Crossed cerebellar diaschisis” in patients with putaminal hemorrhage. J Cereb Blood Flow Metab 3 (Suppl 1):S27-S28
Kempinsky WH (1958) Experimental study of distant effects of acute focal brain injury: A study of diaschisis. Arch Neurol Psychiat 79:376–389
Lassen NA, Henriksen L, Paulson O (1981) Regional cerebral blood flow in stroke by 133Xenon inhalation and emisson tomography. Stroke 12:284–288
Martin WRW, Raichle ME (1983) Cerebellar blood flow and metabolism in cerebral hemispheric infarction. Ann Neurol 14:168–176
Meneghetti G, Vorstrup S, Mickey B, Lindewald H, Lassen NA (1984) Crossed cerebellar diaschisis in ischemic stroke: A study of regional cerebral blood flow by 133Xe inhalation and single photon emission computerized tomogrpahy. J Cereb Blood Flow Metab 4:235–240
Nowotnik DP, Canning LR, Cumming SA (1985) Development of a 99Tcm-labelled radiopharmaceutical for cerebral blood flow imaging. Nucl Med Comm 6:499–506
Palvölgyi R (1969) Regional cerebral blood flow in patients with intracranial tumors. J Neurosurg 31:149–163
Rhodes CG, Wise RSJ, Gibbs JM, Frackowiak RSJ, Hatazawa J, Palmer AJ, Thomas DGT, Jones T (1983) In vivo disturbance of the oxidative metabolism of glucose in human cerebral gliomas. Ann Neurol 14:614–626
Sharp PF, Smith FW, Gemmell HG (1986) Technetium-99m HM-PAO stereoisomers as potential agents for imaging regional cerebral blood flow: Human volunteer studies. J Nucl Med 27:171–177
Shepp LA, Logan BF (1974) The Fourier reconstruction of a head section. IEEE Trans Nucl Sci NS-21:21–43
Vorstrup S, Hemmingsen R, Henriksen L, Lindewald H, Engell HC, Lassen NA (1983) Regional cerebral blood flow in patients with transient ischemic attacks studied by xenon-133 inhalation and emission tomography. Stroke 14:903–910
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Lindegaard, M.W., Skretting, A., Hager, B. et al. Cerebral and cerebellar uptake of 99mTc-(d,1)-hexamethyl-propyleneamine oxime (HM-PAO) in patients with brain tumor studied by single photon emission computerized tomography. Eur J Nucl Med 12, 417–420 (1986). https://doi.org/10.1007/BF00254743
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DOI: https://doi.org/10.1007/BF00254743