Abstract:
PET activation studies employing the autoradiographic technique
and 15O- water or 15O-butanol use the difference between images acquired
under baseline conditions and during activation to detect focal changes
in cerebral blood flow which occur upon stimulus presentation.
Typically, the activating task or baseline conditions are maintained
throughout the entire imaging period. Simulations of the kinetics of
these freely diffusible tracers suggest there may be an advantage to
switching between activation and baseline conditions during the course
of the study which results in images which maximize the difference
signal rather than seeking to quantitate blood flow. We examine the
potential of these switched protocols to increase signal-to-noise (S/N)
in PET activation studies. METHODS: We examined S/N in activation
studies using both-standard and switched paradigms with a simple
switched protocol and dynamic three-dimensional PET data from human
subjects. With tracer kinetic simulations, we investigated the
sensitivity of the S/N gain to factors such as the shape of the input
function, the time at which the conditions are switched and the
magnitude of the activation. RESULTS: In human studies of activation
sites in the visual cortex, primary motor and premotor areas, S/N
improvements of 20%-30% were detected using the switched paradigms.
Simulations show that this gain is virtually independent of activation
magnitude and that there is a broad time window of 20 sec for making the
switch between conditions. To obtain the highest S/N gain, a rapid bolus
injection is required. CONCLUSION: Switched paradigms have the potential
to significantly increase S/N in PET activation studies. In human
studies, the S/N increase averaged 25% which is equivalent to increasing
the number of counts collected by 50%. Switched paradigms can be used to
maximize the difference signal in many activation studies, and do not
preclude the absolute quantitation of blood flow using the standard
autoradiographic technique