| Imaging of hypoxic-ischemic penumbra with (18)F-fluoromisonidazole PET/CT and measurement of related cerebral metabolism in aneurysmal subarachnoid hemorrhage. | |
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MedLine Citation:
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PMID: 19773799 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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This study aimed to characterize hypoxic, but salvageable, tissue imaged by (18)F-fluoromisonidazole ((18)F-FMISO), combining with perfusion-computed tomography (PCT) for regional cerebral blood flow (rCBF) measurement and metabolism by microdialysis (MD) in aneurysmal subarachnoidal hemorrhage (SAH) patients. (18)F-FMISO positron-emission tomography (PET)/CT was performed within the period of possible vasospasm (day 6.8+/-3 after SAH) in seven SAH patients. In parallel, rCBF was determined within the MD region of interest (MD-ROI) (n=5). The MD catheter was inserted into the brain parenchyma with highest risk for ischemia; extracellular levels of glutamate and energy metabolites were registered at time of PET and hourly for 10 days. Twelve-month outcome was evaluated. In asymptomatic patients (n=3) no hypoxia was detected and glutamate levels were low (<10 mmol/L), whereas symptomatic patients had higher glutamate concentrations (P<0.001). Increased (18)F-FMISO uptake within the MD-ROI (n=3) was related to higher glutamate levels, while rCBF was above the ischemic range. Hypoxia (increased (18)F-FMISO uptake) was present in symptomatic patients and associated with relevant metabolic derangement of extracellular glutamate levels, whereas energy metabolism and rCBF were preserved. This technique has the potential to improve our understanding of the role of cellular hypoxia in aneurysmal SAH. |
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Authors:
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Asita S Sarrafzadeh; Alexandra Nagel; Marcus Czabanka; Timm Denecke; Peter Vajkoczy; Michail Plotkin |
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Publication Detail:
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Type: Journal Article Date: 2009-09-23 |
Journal Detail:
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Title: Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism Volume: 30 ISSN: 1559-7016 ISO Abbreviation: J. Cereb. Blood Flow Metab. Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2010-01-04 Completed Date: 2010-02-03 Revised Date: 2011-07-20 |
Medline Journal Info:
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Nlm Unique ID: 8112566 Medline TA: J Cereb Blood Flow Metab Country: United States |
Other Details:
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Languages: eng Pagination: 36-45 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Berlin, Germany. asita.sarrafzadeh@charite.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Brain Chemistry / physiology Brain Ischemia / radionuclide imaging* Cerebral Hemorrhage / radionuclide imaging* Cerebrovascular Circulation / physiology Female Glasgow Outcome Scale Glucose / metabolism Glutamic Acid / metabolism Humans Hypoxia, Brain / radionuclide imaging* Image Processing, Computer-Assisted Male Middle Aged Misonidazole / analogs & derivatives*, diagnostic use Nervous System Diseases / etiology, radionuclide imaging Perfusion Pilot Projects Positron-Emission Tomography Prospective Studies Radiopharmaceuticals / diagnostic use* Subarachnoid Hemorrhage / radionuclide imaging* Tomography, X-Ray Computed Vasospasm, Intracranial / radionuclide imaging |
| Chemical | |
Reg. No./Substance:
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0/Radiopharmaceuticals; 13551-87-6/Misonidazole; 13551-89-8/fluoromisonidazole; 50-99-7/Glucose; 56-86-0/Glutamic Acid |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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