Lassen's Equation is a Good Approximation of Permeability-Surface Model: New α Values for 99mTc-HMPAO and 99mTc-ECD

Abstract

Brain perfusion tracers like [99mTc] d,l-hexamethyl-propyeneamine oxime (99mTc-HMPAO) and [99mTc] ethyl-cysteinate dimer (99mTc-ECD) underestimate regional cerebral blood flow (rCBF) at high flow values. To improve linearity between tracer accumulation and rCBF, two different models have been proposed. One is Lassen's correction algorithm for back-diffusion of tracer, and the other is based on the permeability-surface (PS) model for correction of low first-pass extraction. Although both these models have the same goal, they have completely different forms of equation. It was demonstrated that mathematical approximation of the PS model equation leads to Lassen's equation. In this process, the relationship between PS, CBF values and Lassen's parameter was acquired, and how to correct both the back-diffusion and low first-pass extraction was also demonstrated. A computer simulation confirmed that the two models provided similar consequences when the parameter value is chosen according to the relationship found. Lassen's equation can be used to correct not only back-diffusion but also low first-pass extraction. To perform overall correction, the parameter value we have been using for decades may be too weak. I estimated that the parameter value for overall correction of HMPAO would be around 0.5, and that of ECD would be around 0.65.