scholarly journals Analysis of Some Errors in the Measurement of Oxygen Extraction and Oxygen Consumption by the Equilibrium Inhalation Method

1985 ◽  
Vol 5 (4) ◽  
pp. 591-599 ◽  
Author(s):  
John A. Correia ◽  
Nathaniel M. Alpert ◽  
Richard B. Buxton ◽  
Robert H. Ackerman

Some sources of error in the equilibrium inhalation method for the measurement of oxygen extraction fraction and CMRO2 by positron emission computed tomography scanning have been evaluated by computer simulation. Emphasis has been placed on errors that have not been thoroughly studied in past work. These include effects of random statistical errors, systematic errors in arterial blood radioactivity concentrations, and errors due to perturbations of the equilibrium state, to tissue inhomogeneity, and to subject motion.

1988 ◽  
Vol 8 (2) ◽  
pp. 227-235 ◽  
Author(s):  
Iwao Kanno ◽  
Kazuo Uemura ◽  
Schuichi Higano ◽  
Matsutaro Murakami ◽  
Hidehiro Iida ◽  
...  

The oxygen extraction fraction (OEF) at maximally vasodilated tissue in patients with chronic cerebrovascular disease was evaluated using positron emission tomography. The vascular responsiveness to changes in PaCO2 was measured by the H215O autoradiographic method. It was correlated with the resting-state OEF, as estimated using the 15O steady-state method. The subjects comprised 15 patients with unilateral or bilateral occlusion and stenosis of the internal carotid artery or middle cerebral artery or moyamoya disease. In hypercapnia, the scattergram between the OEF and the vascular responsiveness to changes in PaCO2 revealed a significant negative correlation in 11 of 19 studies on these patients, and the OEF at the zero cross point of the regression line with a vascular responsiveness of 0 was 0.53 ± 0.08 (n = 11). This OEF in the resting state corresponds to exhaustion of the capacity for vasodilation. The vasodilatory capacity is discussed in relation to the lower limit of autoregulation.


Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Takahisa Mori ◽  
Tomonori Iwata ◽  
Yuhei Tanno ◽  
Shigen Kasakura ◽  
Yoshinori Aoyagi ◽  
...  

Background: It is required to anticipate cerebral hyperperfusion syndrome (CHS) following carotid artery stenting (CAS). Purpose: The purpose of our retrospective study was to investigate whether or not blood sampling oxygen extraction fraction (OEF) and post-CAS CBF increase in SPECT had relation to CHS following CAS. Methods: Included in our analysis were patients (1) who underwent elective CAS in our institution between October 2010 and May 2014, and (2) who underwent blood sampling for OEF calculation before and immediately after CAS, and (3) who underwent SPECT before and just after CAS. OEF was calculated from cerebral arteriovenous oxygen difference. Arterial blood was sampled from the common carotid artery and venous blood from the dominant-sided superior jugular bulb. CHS was defined as pulsatile headaches, restlessness, convulsion, and/or new neurological symptoms not due to cerebral ischemia within seven days following CAS. CBF was measured before and just after CAS. CBF increase in the CAS side was defined as follows; (post-CAS CBF ratio - pre-CAS CBF ratio) of more than 10%, where CBF ratio was defined as CAS-sided fronto-parietal CBF divided by ipsilateral cerebellar CBF (%). Evaluated were baseline features in patients, pre-CAS OEF, post-CAS OEF, CBF ratio, CBF increase and CHS. Results: During the study period, 134 patients matched our criteria for analysis. Pre-CAS OEF was 0.41+-0.06, post-CAS OEF was 0.42+-0.08, pre-CAS CBF ratio: 88.7+-15.4%, CBF increase: 1.86+-12.3%. Nine patients presented CHS. Among them, pre-CAS OEF, CBF ratio and CBF increase were significant. ROC curves showed that pre-CAS OEF of 0.46 (p<0.001, OR: 9.3), CBF ratio of 92%(p<0.05, OR: 6.5), CBF increase of 8.8% (p<0.005, OR: 6.6) were cut-off values. Among 10 patients with pre-CAS OEF of more than 0.46 and CBF increase of more than 8.8%, 4 patients presented CHS (p<0.0001, OR;15.9). Conclusion: Elevation of pre-CAS OEF and increase of post-CAS CBF were strongly related to CHS.


2020 ◽  
Vol 85 (1) ◽  
pp. 290-297
Author(s):  
Dengrong Jiang ◽  
Shengwen Deng ◽  
Crystal G. Franklin ◽  
Michael O'Boyle ◽  
Wei Zhang ◽  
...  

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e018560 ◽  
Author(s):  
Klaus Ulrik Koch ◽  
Anna Tietze ◽  
Joel Aanerud ◽  
Gorm von Öettingen ◽  
Niels Juul ◽  
...  

IntroductionDuring brain tumour surgery, vasopressor drugs are commonly administered to increase mean arterial blood pressure with the aim of maintaining sufficient cerebral perfusion pressure. Studies of the commonly used vasopressors show that brain oxygen saturation is reduced after phenylephrine administration, but unaltered by ephedrine administration. These findings may be explained by different effects of phenylephrine and ephedrine on the cerebral microcirculation, in particular the capillary transit-time heterogeneity, which determines oxygen extraction efficacy. We hypothesised that phenylephrine is associated with an increase in capillary transit-time heterogeneity and a reduction in cerebral metabolic rate of oxygen compared with ephedrine. Using MRI and positron emission tomography (PET) as measurements in anaesthetised patients with brain tumours, this study will examine whether phenylephrine administration elevates capillary transit-time heterogeneity more than ephedrine, thereby reducing brain oxygenation.Methods and analysisThis is a double-blind, randomised clinical trial including 48 patients scheduled for surgical brain tumour removal. Prior to imaging and surgery, anaesthetised patients will be randomised to receive either phenylephrine or ephedrine infusion until mean arterial blood pressure increases to above 60 mm Hg or 20% above baseline. Twenty-four patients were allocated to MRI and another 24 patients to PET examination. MRI measurements include cerebral blood flow, capillary transit-time heterogeneity, cerebral blood volume, blood mean transit time, and calculated oxygen extraction fraction and cerebral metabolic rate of oxygen for negligible tissue oxygen extraction. PET measurements include cerebral metabolic rate of oxygen, cerebral blood flow and oxygen extraction fraction. Surgery is initiated after MRI/PET measurements and subdural intracranial pressure is measured.Ethics and disseminationThis study was approved by the Central Denmark Region Committee on Health Research Ethics (12 June 2015; 1-10-72-116-15). Results will be disseminated via peer-reviewed publication and presentation at international conferences.Trial registration numberNCT02713087; Pre-results. 2015-001359-60; Pre-results.


Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
John Lee ◽  
James Sagar ◽  
Gregory Zipfel ◽  
Allyson Zazulia ◽  
Colin Derdeyn

PURPOSE: Chronic hemodynamic impairment may lead to reduced cortical thickness, perhaps related to metabolic down-regulation in cortical neurons. The purpose of this study was to determine whether hemodynamic impairment correlated with diminished cortical thickness in patients with idiopathic moyamoya phenomenon. METHODS: The study was a retrospective analysis of a prospective, blindly-adjudicated, multicenter patient cohort. Inclusion criteria required moyamoya phenomenon diagnosed by catheter angiography and presumed idiopathic basal arterial occlusive disease. Oxygen extraction fraction (OEF) was measured using positron emission tomography (PET). Hemodynamic impairment was determined by comparing the OEF of middle cerebral artery territories to cerebellar regions and to normal control subjects. MR imaging was obtained concurrently with PET, within several hours, and cortical thickness estimates were made with Freesurfer (http://surfer.nmr.mgh.harvard.edu). OEF measurements were then compared to cortical thickness measurements. RESULTS: Adequate MR studies were available for 40 subjects. Mean age was 44 years. Eleven were male. Thirty-one had bilateral disease. Three had increased OEF in both hemispheres and four had unilateral increased OEF. Three patients underwent revascularization surgery during follow-up. Robust linear regression of relative cortical thickness to relative OEF is shown below: the slope was -0.02693 (-0.03002, -0.02384), the intercept was 1.022 (1.019, 1.025) at 95% confidence. Pearson’s R-square was 0.9648. CONCLUSIONS: Chronic hemodynamic impairment may be associated with reduced cortical thickness. This may reflect reversible down-regulation or irreversible subclinical ischemic injury. Supported by NINDS RO1 NS051631, 1 UL1 RR024992-01, 1 TL1 RR024995-01 and 1 KL2 RR 024994-01 from the National Center for Research Resources (NCRR).


2010 ◽  
Vol 30 (10) ◽  
pp. 1767-1776 ◽  
Author(s):  
Thomas T Jiang ◽  
Tom O Videen ◽  
Robert L Grubb ◽  
William J Powers ◽  
Colin P Derdeyn

Hemispheric ratios of oxygen extraction fraction (OEF), a proven methodology for the detection of severe hemodynamic impairment and stroke risk, are not sensitive for detecting bilateral hemispheric increases in OEF. The aim of this study was to investigate the use of cerebellum as the reference normal. We analyzed positron emission tomographic (PET) measurements of count-based OEF and clinical data from 57 patients with unilateral atherosclerotic carotid occlusion and 13 controls enrolled in a prospective study of stroke risk. The ipsilateral, contralateral, and total cerebellum were each evaluated as possible reference regions, and the ratios of the middle cerebral artery (MCA) hemispheric OEF counts against those in each reference region were determined. A statistically significant correlation ( P<0.0001) was observed with all three MCA-to-cerebellar ratios when compared with the gold standard of ipsilateral-to-contralateral MCA hemispheric ratio. Kaplan–Meier analyses showed all MCA-to-cerebellar ratios to be predictive of stroke. By using the total cerebellum method, 7 strokes were found to have occurred in 20 patients with increased OEF ( P=0.0007), compared with 7 strokes out of 16 patients with elevated OEF using the ipsilateral or contralateral cerebellum methods ( P<0.0001). These methods may be useful for categorizing the hemodynamic status of patients with bilateral cerebral occlusive diseases, including atherosclerosis and moyamoya, to determine the association with the risk of subsequent stroke.


1988 ◽  
Vol 8 (3) ◽  
pp. 403-410 ◽  
Author(s):  
N. M. Alpert ◽  
R. B. Buxton ◽  
J. A. Correia ◽  
R. M. Katz ◽  
R. H. Ackerman

The analysis of positron emission tomography measurements of oxygen metabolism has been extended to provide a quantitative estimate of end-capillary Po2. The principle of this extension rests on the idea that the oxygen extraction fraction can be used to calculate the end-capillary oxygen saturation of the blood. The relation between oxygen saturation and Po2 is obtained through the oxygen dissociation curve. Our studies show that in addition to the local oxygen extraction fraction, arterial Po2 and pH values are needed in the calculation, whereas fairly large variations in factors such as Pco2, hematocrit, hemoglobin, and plasma protein levels have little or no effect. Rough estimates of end-capillary Po2 can be made using standard o2 dissociation nomograms. Blood gas and acid-base properties of blood have been known for decades, making it possible to account accurately for individual differences that may be encountered when studying patients. Measurements in nine normal subjects yielded a mean end-capillary Po2 value of 31.2 mm Hg. The ability to make a quantitative visualization of altered patterns of end-capillary Po2 provides an additional dimension to the investigation of stroke disease and tumor metabolism.


2015 ◽  
Vol 36 (8) ◽  
pp. 1424-1433 ◽  
Author(s):  
Kohsuke Kudo ◽  
Tian Liu ◽  
Toshiyuki Murakami ◽  
Jonathan Goodwin ◽  
Ikuko Uwano ◽  
...  

The purposes of this study are to establish oxygen extraction fraction (OEF) measurements using quantitative susceptibility mapping (QSM) of magnetic resonance imaging (MRI), and to compare QSM–OEF data with the gold standard 15O positron emission tomography (PET). Twenty-six patients with chronic unilateral internal carotid artery or middle cerebral artery stenosis or occlusion, and 15 normal subjects were included. MRI scans were conducted using a 3.0 Tesla scanner with a three-dimensional spoiled gradient recalled sequence. QSM images were created using the morphology-enabled dipole inversion method, and OEF maps were generated from QSM images using extraction of venous susceptibility induced by deoxygenated hemoglobin. Significant correlation of relative OEF ratio to contra-lateral hemisphere between QSM–OEF and PET–OEF was observed (r = 0.62, p < 0.001). The local (intra-section) correlation was also significant (r = 0.52, p < 0.001) in patients with increased PET–OEF. The sensitivity and specificity of OEF increase in QSM was 0.63 (5/8) and 0.89 (16/18), respectively, in comparison with PET. In conclusion, good correlation was achieved between QSM–OEF and PET–OEF in the identification of elevated OEF in affected hemispheres of patients with unilateral chronic steno-occlusive disease.


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