Brain ischemia and infarction positively visualized by pyruvate-1-11C using positron-emission tomography

We describe positron-emission tomography (PET) scintigraphic findings obtained using pyruvate-1-11C in eight patients with cerebral ischemic hypoxia or infarction. The extraction of 11C by brain tissue from blood after an i.v. injection of 11C-pyruvate was very rapid, being almost complete after a single circulatory passage. Most ischemic lesions were found to be more or less deficient with regard to 11C-extraction capacity. With time, however, the ratio of 11C in ischemic tissue to that in normal tissue was inverted, and the ischemic lesion appeared as a 'hot' area in the scintigram. Very old infarcts did not exhibit this phenomenon. These observations indicate the usefulness of an 11C-pyruvate PET scan for the diagnosis of therapeutically restorable brain damage.