Comparison of technetium-99m-HMPAO and xenon-133 measurements of regional cerebral blood flow by SPECT

J. Kelly Payne, Madhukar H. Trivedi, Michael D. Devous

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34 Scopus citations


This study compares 99mTc-HMPAO count ratios and derived regional cerebral blood flow (rCBF) to 133Xe rCBF ratios and true rCBF (ml/min/100 g), respectively. Methods: Technetium-99m-HMPAO distribution was evaluated in 14 patients and 5 normal control subjects. Immediately after 133Xe SPECT, subjects received 22 ± 4mCi 99mTc-HMPAO, and images were acquired 15 min after injection. rCBF (mVmin/100 g, 133Xe) or regional count density (99mTc-HMPAO) were extracted from 24 ROI located 6 cm above the cantho- meatal line. These data were also normalized to global cerebral blood flow (gCBF) for 133Xe or to global count density (gCD) for 99mTc-HMPAO. Technetium-99m-HMPAO ROI data also were expressed in units of ml/min/100 g by relating gCD to gCBF. Comparisons between 133Xe and 99mTc-HMPAO were evaluated using a Bonferroni-corrected paired t-test and by linear regression analysis. Results: Profile plots demonstrated agreement in the pattern of relative distribution between rCBF ratios (133Xe) and count density ratios (99mTc-HMPAO). Regression analysis indicated a significant correlation (r = 0.78), with a modest slope (0.52) and a large intercept (0.48). A closer correlation (r = 0.92) was found for the comparison between rCBF (133Xe) and derived 99mTc-HMPAO rCBF. The slope was closer to one (0.82) and the intercept closer to zero. This relationship was also examined during high rCBF after a subset of these subjects (n = 7) was injected intravenously with 1 g acetazolamide. Again, profile plots and regression analysis demonstrated agreement in the pattern of distribution (ratios) between 133Xe and 99mTc-HMPAO (r = 0.66). However, the slope was reduced and the intercept increased relative to resting data. Absolute flow correlations showed some improvement relative to the ratio data (r = 0.77). Conclusion: The distribution of 99mTc-HMPAO is linearly related to rCBF measured by 133Xe SPECT, although our data suggest that 99mTc-HMPAO mildly underestimates rCBF above 80 ml/min/100 g. These results are similar to our previous comparison of 99mTc-ECD and 133Xe.

Original languageEnglish (US)
Pages (from-to)1735-1740
Number of pages6
JournalJournal of Nuclear Medicine
Issue number10
StatePublished - Oct 1 1996


  • acetazolamide
  • regional cerebral blood flow
  • technetium-99m-HMPAO
  • xenon-133

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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