[Creation of a Stereo-paired Bone Anatomical Chart Using Human Bone Specimens for X-ray Anatomical Education Part III: Addition of Anaglyph Three-dimensional Images for Those Who Hardly See Stereo-paired Photographs with the Naked Eye].

We published a report entitled "Creation of a stereo-paired bone anatomical chart using human bone specimen for radiation education" in this journal in order to accurately understand the surface structure and three-dimensional structure of bones, and assist in bone image interpretation. However, some people cannot see stereoscopically with the naked eye. Therefore, we created anaglyph three-dimensional (3D) images from stereo-paired images of the stereo X-ray anatomical chart of the bone specimen. The anaglyph of the bone surface and X-ray images facilitates stereoscopic viewing with red-blue 3D glasses. The stereo X-ray anatomical chart of the bone specimen with anaglyph 3D images was converted into an electronic data file in the same manner as the stereo X-ray anatomical chart of the bone specimen, which can be easily used in any radiological examination rooms or at home through an electronic medium. We made it possible to perform correlative stereoscopic observations of the bone surface and X-ray images using red-blue 3D glasses.

[Creation of Bone X-ray Radiography Manual Using Human Bone Specimens for Bone X-ray Radiography Education].

Senior radiological technologists have made various improvements and have supported the clinical and educational fields by explaining bone X-ray radiography to students and junior radiological technologists to understand the procedure using illustrations, X-ray images, and photographs in a way that corresponds to the design software available for that era. Because human bone specimens are only available in the anatomy laboratory of medical schools, they could not be used for the explanation of bone X-ray radiography until now. Therefore, we have developed a bone X-ray radiography manual using bone specimens for the bone X-ray radiography education, which helps students to understand the procedure of bone X-ray radiography. Previous bone X-ray radiography manuals had not been illustrated by bone specimens and bone specimen X-ray images, but this bone X-ray radiography manual using bone specimens has made it possible to understand the surface morphology of bone specimens and X-ray images of them. In addition, the data of bone X-ray radiography using this bone specimen were made into an electronic file, which can be easily used at the place of radiological examination or at home through electronic media.

[Creation of Stereo-paired Color Vascular Anatomical Charts Using 3-dimentional Images].

Three-dimensional (3D) images of blood vessels in the human body, which are acquired by X-ray computed tomography (CT) and cone-beam CT of Angiography devices, are widely used in medical diagnosis and treatment. Using the 3DCT images of blood vessels, we created stereo-paired color vascular anatomical charts for better understanding of vascular anatomy in clinical settings, patient explanations, and student education. Since it is difficult to distinguish branches of blood vessels that show three-dimensionally complicated running such as cerebral blood vessels, we made it easier to identify them anatomically by color-coding each branch of the blood vessel. Also, by using stereo-paired images, we can see the three-dimensional blood vessel running. In the past anatomical books and vascular anatomy atlas, there was no anatomical chart of the whole body blood vessels that could be color-coded and stereoscopically viewed. We have made it possible to identify blood vessels by the stereoscopic vision of the blood vessels using this stereo-paired color anatomical chart. In addition, this vascular anatomical chart can be additionally revised according to the needs of the clinical and educational settings to be used, and the data can be converted into an electronic file so that it can be easily used in the field of radiological examination or at home through electronic media.

[Investigation of the Administration Accuracy of an Auto Infusion Device in 18F-FDG PET].

PURPOSE: The administration accuracy of the automated infusion device for the positron emission radiopharmaceutical affects to calculation of the standardized uptake value (SUV) in 18F-fluorodeoxyglucose (18F-FDG) PET examination. The purpose of this study was to investigate the administration error in the clinical use of an automated infusion device for quantitative management in PET examination. METHODS: We assumed clinical use of the automated infusion device and investigated two types of administration errors. First, for investigating the administration error over time in a day (errorday), a total of 13 infusion works were performed every 30 minutes. Second, for investigating the long period administration error (errorperiod), the infusion work was performed once before clinical use of an automated infusion device. The dispensed radioactivity was set to 150 MBq. The administration error was calculated using output values from the automated infusion device and measured values from the dose calibrator. RESULTS: The administration errorday was 0.9±1.3%, and the maximum error was 2.7%. The administration errorperiod was 1.1±2.0%, and the maximum error was 5.9%. CONCLUSION: We investigated the administration error of the automated infusion device. We confirmed the approximately 1% administration error and high-accuracy injection in an automated-device method.

[Creation of a Stereo-paired Bone Anatomical Chart Using Human Bone Specimens for X-ray Anatomical Education Part II: Addition of Stereo-paired X-ray Bone Images to the Anatomical Chart].

In a previous issue of this journal, we published a report entitled "Creation of Stereo-paired Bone Anatomical Charts Using Human Bone Specimens for Radiation Education" To understand how the bone specimen is visualized as an X-ray image, we newly created a bone specimen stereo-paired X-ray anatomical chart by adding the X-ray images of the same bone specimen. When a bone is X-rayed, the surface structure and internal structure of the bone are visualized as a composite image of the difference in X-ray absorption, and each bone becomes a unique X-ray image. Therefore, we took stereo-paired X-ray images of the bone specimens by the same method as the stereo-paired anatomical chart of the bone specimens. Then, we arranged the stereo-paired X-ray images and surface images of the same bone specimen in the one sheet to be readily compared. Similar to the previous bone specimen anatomical charts, these data of X-ray image anatomical chart were also made into an electronic file, so that we can do the three-dimensional observation of bone X-ray images even at the place of radiological examination or at home through electronic media. Until now, none of the specialized anatomy books and pictorial books are available for stereoscopic viewing of bone specimens and bone X-ray images. However, this stereo-paired X-ray image anatomical chart enabled us to learn accurate three-dimensionalization of bones by comparing the bone surface morphology and bone X-ray images.

Effect of quantitative values on shortened acquisition duration in brain tumor 11C-methionine PET/CT.

BACKGROUND: The amount of signal decreases when the acquisition duration is shortened. However, it is not clear how this affects the quantitative values. This study aims to clarify the effect of acquisition time shortening in brain tumor PET/CT using 11C-methionine on the quantitative values. METHOD: This study was a retrospective analysis of 30 patients who underwent clinical 11C-methionine PET/CT examination. PET images were acquired in list mode for 10 min. PET images of acquisition duration from 1 to 10 min with 1-min step were reconstructed. We examined the effect on the quantitative values of acquisition duration. We placed a volume of interest to include the entire tumor and regions of interest in the shape of a large crescent in the contralateral hemisphere in 5 contiguous axial slices as normal tissue. Quantitative values examined were maximum, peak, and mean standardized uptake values (SUVmax, SUVpeak, SUVmean), metabolic tumor volume (MTV), and maximum tumor to normal tissue ratio (TNRmax), with each duration compared to that with 10 min. RESULTS: SUVmax, MTV, and TNRmax showed the highest values due to the effects of statistical noise when the acquisition time was 1 min. These values were stable when the acquisition duration was > 6 min. SUVpeak and SUVmean showed mostly consistent values regardless of duration. CONCLUSIONS: SUVmax, MTV, and TNRmax are affected by acquisition time. If the acquisition duration was > 6 min, the fluctuation could be suppressed within 5% in these quantitative values. However, SUVpeak was suggested to be a robust index regardless of the acquisition duration.

[Investigation of Radioactivity Concentration of the Normal Brain Region for the Phantom Experiment in Brain Tumor PET Imaging].

PURPOSE: There are few reports focusing on the radioactivity concentration in the normal brain region for the phantom experiment. We investigated the radioactivity concentration of normal brain regions for the phantom experiment of brain tumor PET imaging. METHODS: A total of 30 patients (age: 53±19 years old, body weight: 58±11 kg) underwent the brain tumor PET examinations using 18F-fluorothymidine (18F-FLT), 18F-fluoromisonidazole (18F-FMISO) and 11C-methionine (11C-MET) during April 1, 2017-October 1, 2017. A region of interest was set in the brain parenchyma excluding the tumor lesion area and the ventricle in PET image, and radioactivity concentrations of the normal brain region were obtained. RESULTS: The radioactivity concentrations of the normal brain region were 0.79±0.25 kBq/ml for 18F-FLT, 2.34±0.42 kBq/ml for 18F-FMISO and 4.05±0.80 kBq/ml for 11C-MET. CONCLUSION: We proposed the radioactivity concentrations of background region in the phantom for brain tumor PET imaging using 18F-FLT, 18F-FMISO and 11C-MET.

Applicability of emission-based attenuation map for rapid CBF, OEF, and CMRO2 measurements using gaseous (15)O-labeled compounds.

BACKGROUND: Cerebral blood flow (CBF), oxygen extraction fraction (OEF), and cerebral metabolic rate of oxygen (CMRO2) images have facilitated understanding of the pathophysiological basis of cerebrovascular disorders. Such parametric images can be rapidly, measured within around 15 min, using positron emission tomography (PET) with sequentially administered (15)O-labeled oxygen and water. For further shortening, one option is to eliminate the transmission scan by applying an emission-based attenuation correction. METHODS: The validity of the present method was tested by comparing parametric values with emission-based attenuation correction to those with transmission-based correction. This was applied to 27 subjects who were diagnosed with or without cerebrovascular disorders. All subjects received the rapid CBF/OEF/CMRO2 PET measurements. An emission-based attenuation map was generated by estimating the edge of the brain tissue contour on an obtained sinogram and by assuming the uniform tissue coefficient to be 0.1 cm(-1). Then images were reconstructed, and parametric images were computed. RESULTS: No difference was apparent between the emission- and transmission-based methods. Paired t-test showed no significant differences in CBF, OEF, or CMRO2 values between the emission- and transmission-based methods, except in the parietal and occipital and cerebellum and occipital regions, and the differences were less than 10%. The regression analysis showed a close correlation of r = 0.89 to 0.99. CONCLUSIONS: The present study revealed that the attenuation correction can be performed by the emission-based estimation method and clinical PET duration can be shortened for the CBF, OEF, and CMRO2 gas study.

Imaging of the appearance time of cerebral blood using [15O]H2O PET for the computation of correct CBF.

BACKGROUND: Quantification of cerebral blood flow (CBF) is important for the understanding of normal and pathologic brain physiology. Positron emission tomography (PET) with H215O (or C15O2) can quantify CBF and apply kinetic analyses, including autoradiography (ARG) and the basis function methods (BFM). These approaches, however, are sensitive to input function errors such as the appearance time of cerebral blood (ATB), known as the delay time. We estimated brain ATB in an image-based fashion to correct CBF by accounting for differences in computed CBF values using three different analyses: ARG and BFM with and without fixing the partition coefficient. METHODS: Subject groups included those with no significant disorders, those with elevated cerebral blood volume, and those with reduced CBF. All subjects underwent PET examination, and CBF was estimated using the three analyses. The ATB was then computed from the differences of the obtained CBF values, and ATB-corrected CBF values were computed. ATB was also estimated for regions of interest (ROIs) of multiple cortical regions. The feasibility of the present method was tested in a simulation study. RESULTS: There were no significant differences in the obtained ATB between the image- and ROI-based methods. Significantly later appearance was found in the cerebellum compared to other brain regions for all groups. In cortical regions where CBF was reduced due to occlusive lesions, the ATB was 0.2 ± 1.2 s, which was significantly delayed relative to the contralateral regions. A simulation study showed that the ATB-corrected CBF was less sensitive to errors in input function, and noise on the tissue curve did not enhance the degree of noise on ATB-corrected CBF image. CONCLUSIONS: This study demonstrates the potential utility of visualizing the ATB in the brain, enabling the determination of CBF with less sensitivity to error in input function.

Omission of [(15)O]CO scan for PET CMRO(2) examination using (15)O-labelled compounds.

OBJECTIVE: CBF, OEF and CMRO(2) provide us important clinical indices and are used for assessing ischemic degree in cerebrovascular disorders. These quantitative images can be measured by PET using (15)O-labelled tracers such as C(15)O, C(15)O(2) and (15)O(2). To reduce the time of scan, one possibility is to omit the use of CBV data. The present study investigated the influence of fixing the CBV to OEF and CMRO(2) values on subjects with and without cerebrovascular disorders. METHODS: The study consisted of three groups, namely, GROUP-0 (n = 10), GROUP-1 (n = 9), and GROUP-2 (n = 10), corresponding to--without significant disorder, with elevated CBV, and with reduced CBF and elevated OEF, respectively. All subjects received PET examination and using the PET data OEF and CMRO(2) images were computed by fixing CBV and with CBV data. The computed OEF and CMRO(2) values were compared between the methods. RESULTS: The OEF and CMRO(2) values obtained by fixing the CBV were around 10% underestimation against that with CBV data. The regression analysis showed that these values were comparable (r = 0.93-0.98, P < 0.001). The simulation showed that fixing of the CBV would not derive significant error in either OEF or CMRO(2) values, when changed from 0 to 0.08 ml/g. CONCLUSION: This study shows the feasibility of fixing the CBV value for computing OEF and CMRO(2) values in the PET examination, suggesting the CO scan could be eliminated.

Shortening the duration of [18F]FDG PET brain examination for diagnosis of brain glioma.

PURPOSE: Some patients cannot remain immobile for a long duration of 60 min, which is generally applied in the case of a 2-deoxy-2-[(18)F]fluoro-D-glucose ([(18)F]FDG) dynamic positron emission tomography (PET) scan. We investigated the change of the parametric values when the time duration of PET data was shortened. PROCEDURES: Eight normal subjects and four subjects with brain glioma were studied. The rate values of K(1), k(2), k(3), and K(i) parametric images were computed by changing the time duration from 20 to 60 min, and changes of those parametric values were compared. RESULTS: The change was 20-30% and 3-5% for k(3) and K(i), respectively, when the scan time was shortened from 60 to 40 min. The ratios of normal and disease regions in k(3) and K(i) values were similar, and contrasts of those images were not changed when the scan time was shortened to 40 min. CONCLUSIONS: These results demonstrate that the short time duration of [(18)F]FDG PET examination can provide an acceptable estimation of parametric k(3) and K(i) images.

Diagnostic value of kinetic analysis using dynamic FDG PET in immunocompetent patients with primary CNS lymphoma.

PURPOSE: The purpose of this study was to investigate the accumulation of FDG in immunocompetent patients with primary central nervous system (CNS) lymphoma using qualitative and quantitative PET images and to compare baseline with follow-up PET after therapy. METHODS: Twelve immunocompetent patients with CNS lymphoma were examined. Dynamic emission data were acquired for 60 min immediately following injection of FDG. In seven patients, repeated PET studies were performed after treatment. Applying a three-compartment five-parameter model, K (1), k (2), k (3), k (4), vascular fraction (V ( B )) and cerebral metabolic rate of glucose (CMR(Glc)) were obtained. We evaluated the FDG uptake visually using qualitative and parametric images and quantitatively using parametric images. RESULTS: A total of 12 lesions were identified in ten patients with newly diagnosed CNS lymphoma. On visual analysis, ten lesions showed an increase on qualitative images, eight showed an increase on K (1) images, 12 showed an increase on k (3) images and ten showed an increase on CMR(Glc) images. On quantitative analysis, k (2), k (3) and CMR(Glc) values of the lesion were significantly different from those of the normal grey matter (p<0.02-0.0005). A total of three lesions were identified in two patients with recurrent tumour. All three lesions showed an increase on qualitative, k (3) and CMR(Glc) images. The K (1), k (2), k (3) and CMR(Glc) values after treatment were significantly different from those obtained before treatment (p<0.04-0.008). CONCLUSION: Kinetic analysis, especially with respect to k (3), using dynamic FDG PET might be helpful for diagnosis of CNS lymphoma and for monitoring therapeutic assessment.

Magnetic resonance imaging and positron emission tomography findings in status epilepticus following severe hypoglycemia.

We recently experienced a case with asymmetrical cortical abnormality on MRI with focal status epilepticus following severe hypoglycemia. The cerebral blood flow and metabolisms for oxygen and glucose were determined using positron emission tomography (PET) during focal status epilepticus following severe hypoglycemia and at the follow-up period. Prolonged seizure activity produced profound glucose hypermetabolism and mild hyperemia in the region of the presumed cortical focus of epilepsy and in structures anatomically remote from the focus, corresponding to the areas of abnormal signal intensity on the MRI. The patient remained comatose and exhibited a diffuse hypoperfusion/hypometabolism and symmetrical brain atrophy on the follow-up PET and MRI, respectively. Cytotoxic brain edema due to profound glucose metabolism without compensatory increase of the blood flow during status epilepticus may account for the brain abnormality observed on the early MRI. Simultaneous examination of the cerebral blood flow and metabolism using PET can provide useful information about the pathology in patients with status epilepticus.

A case of non-hodgkin's lymphoma of the ovary: usefulness of 18F-FDG PET for staging and assessment of the therapeutic response.

Primary ovarian lymphoma as the initial manifestation is rare. A 27-year-old woman presented to our hospital with the symptoms of lower abdominal fullness and pollakisuria. CT scan and MRI revealed bilateral ovarian tumors, which showed heterogeneous masses. 18F-FDG PET revealed strong uptake by the abdominal masses, and the maximum standardized uptake value (SUVmax) was 12.5. Abnormal uptake was not shown by other regions. An exploratory laparotomy was performed. Histological findings revealed diffuse large B-cell lymphoma. The clinical stage was IV according to the Ann Arbor system. International prognostic index (IPI) was 3 (high-intermediate risk). Chemotherapy was administered consisting of three courses of an R-CHOP regimen, and 18F-FDG PET and CT scan revealed no signs of involvement 3 months after initiation of the chemotherapy. 18F-FDG PET was a useful method for staging and assessment of the therapeutic response in primary ovarian lymphoma.

Correlation of FDG-PET findings with histopathology in the assessment of response to induction chemoradiotherapy in non-small cell lung cancer.

PURPOSE: The objective of this study was to evaluate the ability of FDG-PET to predict the response of primary tumour and nodal disease to preoperative induction chemoradiotherapy in patients with non-small cell lung cancer (NSCLC). METHODS: FDG-PET studies were performed before and after completion of chemoradiotherapy prior to surgery in 26 patients with NSCLC. FDG-PET imaging was performed at 1 h (early) and 2 h (delayed) after injection. Semi-quantitative analysis was performed using the standardised uptake value (SUV) at the primary tumour. Percent change was calculated according to the following equation: [see text]. Based on histopathological analysis of the specimens obtained at surgery, patients were classified as pathological responders or pathological non-responders. The clinical nodal stage on the post-chemoradiotherapy PET scan was visually determined and compared with the final pathological stage. RESULTS: Eighteen patients were found to be pathological responders and eight to be pathological non-responders. SUV(after) values from both early and delayed images in pathological responders were significantly lower than those in pathological non-responders. The percent change values from early and delayed images in the pathological responders were significantly higher than those in the pathological non-responders. The post-chemoradiotherapy PET scan accurately predicted nodal stage in 22 of 26 patients. CONCLUSION: FDG-PET may have the potential to predict response to induction chemoradiotherapy in patients with NSCLC.

Contribution of whole body FDG-PET to the detection of distant metastasis in pancreatic cancer.

OBJECTIVE: Accurate baseline staging is necessary to appropriately treat pancreatic cancer. The present study was undertaken to evaluate the clinical contribution of whole body FDG-PET to the detection of distant metastasis in pancreatic cancer. METHODS: A total of consecutive 42 patients with previously untreated pancreatic cancer were examined. Whole body FDG-PET imaging for initial staging was performed with a 3D acquisition and iterative reconstruction on Siemens ECAT HR+ scanner at 1 hour post 185-200 MBq 18F-FDG injection. PET findings were correlated with clinical and radiological data to determine the impact of PET on staging. RESULTS: In 16 patients, there were one or more sites of metastasis based on clinical data. FDG-PET correctly identified the presence of metastasis in 13 of 16 patients and its absence in 23 of the remaining 26 patients. Thus, FDG-PET missed 4 metastatic sites in 4 patients (liver and lung metastasis). FDG-PET correctly identified 8 metastatic sites in 7 patients (peritoneal dissemination and liver, bone and supraclavicular lymph node metastasis), which were missed on CT imaging. Based on whole body FDG-PET, the clinical stage was changed in 5 of 42 patients (11.9%). CONCLUSIONS: These results suggest that FDG-PET and CT appear to have a complementary role in the detection of distant metastasis in patients with pancreatic cancer.

Evaluation of delayed additional FDG PET imaging in patients with pancreatic tumour.

AIM: To evaluate whether delayed fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging is more helpful in differentiating between malignant and benign lesions and whether delayed FDG PET imaging can identify more lesions in patients in whom pancreatic cancer is suspected. METHODS: The study evaluated 86 patients who were suspected of having pancreatic tumours. FDG PET imaging (whole body) was performed at 1 h (early) post-injection and repeated 2 h (delayed) after injection only in the abdominal region. Qualitative and semi-quantitative evaluation was performed. The semi-quantitative analysis was performed using the standardized uptake value (SUV), obtained from early and delayed images (SUVearly and SUVdelayed, respectively). Retention index (RI) was calculated according to the equation: (SUVdelayed-SUVearly)x100/SUVearly. RESULTS: The final diagnosis was pancreatic cancer in 55 and benign disease in 31 patients. On visual and semi-quantitative analysis, the diagnostic accuracy of RI was the highest (88%). The differences between the SUVearly, SUVdelayed and RI value in both pancreatic cancer and benign disease were significant (P<0.01). The mean value of SUVdelayed was significantly higher than that of SUVearly (P<0.01) in pancreatic cancer. Furthermore, new foci of metastasis were seen in the liver in two patients and in the lymph node in one patient only on delayed images. CONCLUSIONS: The RI values obtained using early and delayed FDG PET may help in evaluating pancreatic cancer. Furthermore, addition of delayed FDG PET imaging is helpful to identify more lesions in patients with pancreatic cancer.

Usefulness of FDG-PET imaging for the radiotherapy treatment planning of pyothorax-associated lymphoma.

Pyothorax-associated lymphoma (PAL) is a non-Hodgkin's lymphoma developing in the pleural cavity after a long-standing history of chronic pyothorax (CP). F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) imaging is a useful modality for determination of disease extent of various malignant tumors, including malignant lymphoma, but there have been no reports describing the usefulness of FDG-PET imaging in PAL. Here we report a case of PAL that relapsed after chemotherapy and was successfully treated by radiotherapy. FDG-PET imaging revealed that the tumor was localized to a soft-tissue attenuation mass behind the CP cavity in the right thorax, but did not infiltrate the CP cavity. A total dose of 40 Gy was administered to the area that included the PET-positive lesion, instead of including the entire CP cavity in the radiation field. Although computed tomography (CT) showed a residual mass, no FDG uptake was indicated by FDG-PET imaging performed just after the end of radiotherapy, and additional irradiation was not performed. No sign of relapse was found by FDG-PET imaging 3 months later. FDG-PET imaging was useful for both the planning of radiotherapy and assessing the treatment response of PAL.

Clinical usefulness of fusion of 131I SPECT and CT images in patients with differentiated thyroid carcinoma.

UNLABELLED: Precise localization of the foci of (131)I uptake for management of patients with differentiated thyroid carcinoma can be difficult because of a lack of anatomic landmarks. The objective of the present study was to demonstrate the clinical usefulness of (131)I SPECT/CT fusion images in patients with differentiated thyroid carcinoma. METHODS: CT and SPECT were performed 7 d after administration of a therapeutic dose of (131)I to 17 patients with differentiated thyroid carcinoma. External markers were placed at 3 locations on the skin of the patient to adjust the sections of CT and SPECT in the same geometric plane. Fusion images were constructed by combining the digital CT and SPECT images on a computer workstation. The data from both planar and SPECT (131)I images and CT images were first separately assessed by 2 nuclear medicine physicians. (131)I SPECT/CT fusion images were then interpreted. Fusion images were considered to improve image interpretation in comparison with CT and scintigraphy separately when they provided better localization of sites of increased radiopharmaceutical uptake. RESULTS: Both CT and (131)I SPECT showed the pathologic sites in 5 of 17 patients (29%). Fusion images were considered to be of benefit in 15 of 17 patients (88%). In 4 patients, CT showed normal-sized lymph nodes, whereas (131)I SPECT showed abnormal findings. In 3 patients with bone metastasis, fusion images confirmed the precision of the localization of abnormal (131)I uptake. Five bone metastases and 1 muscle metastasis were occult and were not seen on the CT images. Finally, (131)I scintigraphy findings were abnormal for 2 patients for whom the CT findings were initially considered normal. Fusion images confirmed the precision of the localization of physiologic (131)I uptake. CONCLUSION: For registration of anatomic and functional images in fusion imaging, the method using external markers was simple and practical. (131)I SPECT/CT fusion images using this technique may improve anatomically limited interpretation of (131)I scintigraphy alone in patients with differentiated thyroid carcinoma.

A study of the acute effect of smoking on cerebral blood flow using 99mTc-ECD SPET.

Cigarette smoking is known to be associated with atherosclerosis, is an important risk factor for stroke and has other serious effects. The aim of this study was to evaluate the acute effect of cigarette smoking on cerebral blood flow using statistical parametric mapping (SPM). Ten healthy volunteers with a smoking habit were studied using technetium-99m-labelled ethylcysteinate dimer single-photon emission tomography (SPET). We evaluated the regional cerebral blood flow under the smoking and resting states. The regional cerebral blood flow on smoking-activated SPET was significantly decreased in the whole brain as compared with that on resting SPET. Our findings therefore suggest that one of the acute effects of cigarette smoking is to induce a diffuse decrease in cerebral blood flow.