Quantitation of local cerebral blood flow and partition coefficient without arterial sampling: theory and validation

A new technique that requires neither arterial blood sampling nor prior knowledge of the indicator's tissue-blood partition coefficient has been developed for quantitation of local CBF. This technique arises from an existing method that uses the inert, freely diffusible gaseous tracer [18F]methyl fluoride (CH3(18)F) and positron computed tomography. The shape of the arterial blood curve is derived from continuous sampling of expired air. The concentration of CH3(18)F in the arterial blood is assumed to be proportional to the expired gas curve interpolated between end-tidal values. The absolute scale of the blood curve is determined by fitting a series of venous blood samples to a multicompartment model. Four validation studies were performed to compare values derived using the venous scaled expired breath input function with those derived using direct arterial samples. The proposed method gave higher flow values than the standard arterial sampling method by an average of 4.4%. These validation studies and data from both normal and patient scans suggest that the method provides the quantitation necessary for interstudy comparisons yet avoids the trauma of an arterial puncture.