Technetium-99m-pertechnetate as a whole blood marker for brain perfusion studies

In the brain, diffusible 99mTc-pertechnetate behaves as an intravascular indicator because it is confined within the circulation by the blood-brain barrier, allowing its use for noninvasive dynamic evaluation of cerebral circulation. For this application 99mTc has often been claimed to be a plasma marker. This study examines the validity of such a claim which has not yet been proven in vivo. METHODS: The relative amount of 99mTc in the red cells circulating in large vessels was compared to the corresponding hematocrit (LV Hct) during the rapid (t/2 = 1.98 min) and slow (t/2 = 84 min) phases of 99mTc disappearance from the circulation after bolus intravenous injection. These comparisons were performed on rats at 2 (n = 3), 5 (n = 6), 10 (n = 6) and 20 (n = 9) sec after intravenous injection for the rapid phase and 5 (n = 5), 30 (n = 4), 60 (n = 6) and 120 (n = 6) min after intravenous injection for the slow phase. RESULTS: The results show that the relative amount of intravascular 99mTc fixed to red cells did not differ statistically from LV Hct until at least 1 hr after intravenous administration. This homogeneous distribution of 99mTc in blood was indisputable during the first 20 sec but became progressively less evident and disappeared after 2 hr. Such behavior was attributed to a progressive increase of free 99mTc, which, in whole blood, amounted to 4% at 20 sec and 25% at 2 hr after injection. CONCLUSION: Because it is a 96% whole blood marker early after intravenous administration, 99mTc is a reliable agent for first-pass studies of whole blood circulation in the brain

Late effects of X irradiation on regulation of cerebral blood flow after whole-brain exposure in rats

Hemodynamic parameters such as total cerebral blood volume (total CBV), cerebral parenchymal blood volume (CBV), cerebral blood flow (CBF) and cerebral blood velocity index were measured in rats 6, 12 and 18 months after single exposures of brain to 5, 10, 15 and 20 Gy X rays for total CBV, CBF and blood velocity index, and only 20 Gy for CBV. Total CBV and blood velocity index were determined by a noninvasive blood dilution method using [99mTc]pertechnetate and CBF by [131I]iodoantipyrine brain extraction. The CBV was obtained from both parenchymal plasma and erythrocyte volumes measured in isolated brain by 125I-labeled serum albumin and 51Cr-labeled erythrocytes, respectively. Neither the dose nor the time after irradiation influenced total CBV. Nevertheless, CBV decreased slightly while CBF decreased strongly at 12 and 18 months after 20 Gy. In contrast, the blood velocity index increased progressively at 12 and 18 months after 15 Gy and at all times after 20 Gy. According to the coexistence in irradiated brains of a remodeling with microvascular occlusions and dilated abnormal vessels, this lowered CBF can be explained by the smaller number of open capillaries and a "steal phenomenon" through low-resistance channels developed in the parenchymal and extraparenchymal vasculatures. Such a "steal phenomenon" is also supported by the response of the blood velocity index, which appears to be the earliest sensitive index for the detection of hemodynamic changes with respect to time (6 months) and dose of radiation (15 Gy)