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J Hatazawa

Publications and source records attributed to J Hatazawa.

At least 91 records · Page 5Linked to original sources

Central benzodiazepine receptor distribution after subcortical hemorrhage evaluated by means of [123I]iomazenil and SPECT.

BACKGROUND AND PURPOSE: [123I]Iomazenil is a single-photon emission computed tomography (SPECT) tracer that selectively binds to central benzodiazepine receptor in the neuron membrane. With this ligand, we studied the central benzodiazepine receptor distribution in the cortex remote from subcortical hematoma in intracerebral hemorrhage patients. METHODS: Four patients with unilateral putaminal hemorrhage and one patient with right thalamic hemorrhage were studied (mean +/- 1 SD age, 50.0 +/- 8.8 years). The initial volume of hematoma ranged from 4.3 to 31.0 mL (mean +/- 1 SD, 17.5 +/- 12.3 mL). SPECT images obtained 3 hours after intravenous administration of [123I]iomazenil (167 MBq/750 ng) were analyzed. In three patients, perfusion was evaluated with [123I]IMP. On SPECT images, the radioactivity ratio of the ipsilateral to the contralateral cerebral cortex (I/C ratio) or of the contralateral to the ipsilateral cerebellar hemisphere (C/I ratio) was measured. RESULTS: The I/C ratio for iomazenil was significantly decreased compared with unity in the temporal lobe (0.84 +/- 0.08, P < .01) and the parietal lobe (0.87 +/- 0.10, P < .05), but the C/I ratio in the cerebellum (1.00 +/- 0.03) was not. The C/I ratio for perfusion in the cerebellar cortex (0.83 +/- 0.04, P < .01) was significantly decreased compared with that in normal subjects. CONCLUSIONS: Central benzodiazepine receptor-[123I]iomazenil binding was decreased in the ipsilateral cerebral cortex remote from the subcortical hematoma. This preliminary result may facilitate further study of the potential damage of the cortical neurons remote from subcortical hematoma.

Cerebral Cortex↗

MR diagnosis of subacute and chronic subarachnoid hemorrhage: comparison with CT.

OBJECTIVE: The purpose of our study was to compare the value of MR imaging with CT in the diagnosis of subarachnoid hemorrhage in the subacute and chronic stages (> 3 days after the hemorrhagic episode). MATERIALS AND METHODS: We performed 42 MR examinations using a 0.5-T unit in 37 patients with subarachnoid hemorrhage caused by a ruptured aneurysm. Examinations were done 4-75 days after the ictus. We obtained 40 T1-weighted, 11 proton density-weighted, 15 T2-weighted, and 28 moderately T2-weighted images. CT was also performed in all patients within 24 hr of the MR examination. Confirmation of the presence of subarachnoid hemorrhage at the time of the MR examination was made by CSF examination using lumbar puncture or surgical findings. RESULTS: In the subacute and chronic stages, subarachnoid hemorrhage was seen as an area of high signal intensity on T1-weighted, proton density-weighted, T2-weighted, and moderately T2-weighted MR images in 63%, 90%, 25%, and 92% of cases, respectively. On CT scans, subarachnoid hemorrhage was seen as an area of high attenuation in only 46% of cases. Especially in the chronic stage, subarachnoid hemorrhage was seen as an area of high signal intensity more frequently by MR imaging than by CT (90% on T1-weighted images; 100% on proton density-weighted images; 25% on T2-weighted images; 100% on moderately T2-weighted images; and 10% on CT scans). High-signal-intensity subarachnoid hemorrhage was demonstrated by MR imaging until a maximum of 39 days after the ictus, whereas high-attenuation subarachnoid hemorrhage was demonstrated by CT until a maximum of 17 days after the ictus. CONCLUSIONS: Our findings show that MR imaging is superior to CT for the diagnosis of subacute and chronic subarachnoid hemorrhage. MR imaging is especially useful for the diagnosis of chronic subarachnoid hemorrhage.

Acute Disease↗

[Kinetics of glucose metabolism in central neurocytomas].

To estimate proliferating activity of central neurocytoma, we measured kinetic rate constants and glucose metabolic rate (kinetic-rCMRGI) using dynamic positron emission tomography (PET), as well as autoradiographic rCMRG1 (arg-rCMRG1), in patients with histologically verified central neurocytoma. The subject included five patients, four males and one female, aged from 23 to 53 years with a mean age of 41 years old. All tumors were located in the lateral ventricle and two extended into the third ventricle through the forearm of Monro. Tumor lesion on the PET images was determined using CT or MRI, which was performed at levels equivalent to those for the PET scans. The kinetic rate constants of tracer transport from blood to brain (k1), reverse transport from brain to blood (k2), and phosphorylation (k3) were analyzed according to the three compartment 18F-fluorodeoxyglucose (FDG) model. For quantitative analysis, regions of interest (ROI) on PET images were delineated on the tumor and the contralateral gray matter. Tumor k1 and k2 values were similar to or higher than those of the contralateral gray matter, suggesting high permeability due to lack of blood-brain barrier. Tumor k3 value, an indicator of hexokinase activity, and kinetic-rCMRG1 were exceedingly lower in three of five patients. These three patients have been free from tumor recurrence or regrowth, postoperatively. The other two patients, tumor kinetic-rCMRG1 was similar to or higher than that of the contralateral gray matter. One patient suffered from tumor regrowth shortly after resection, and the other has been followed up postoperatively. Thus, k3 and kinetic-rCMRG1 are indicative parameters of proliferative activity in central neurocytoma.

Adult↗

[Kinetic analysis of glucose metabolism in meningiomas--comparison with malignant gliomas].

We measured kinetic rate constants and glucose metabolic rate (kinetic-rCMRGl) using dynamic positron emission tomography (PET), as well as regional cerebral blood flow (rCBF), blood volume (rCBV), oxygen extraction fraction (rOEF), oxygen metabolic rate (rCMRO2) and autoradiographic rCMRGl (arg-rCMRGl), in patients with meningioma. Ten patients including one recurrent case, two males and eight females aged from 44 to 71 years with a mean age of 54 years old, were studied prior to surgical interventions. Histological diagnosis was as follows: seven cases of meningothelial type, two cases of angiomatous type and one fibrous type. For quantitative analysis, regions of interest (ROI) on PET images were delineated on the tumor and the contralateral gray matter in comparison with eight cases with malignant gliomas (five cases of malignant astrocytoma and three cases of glioblastoma, aged from 14 to 70 years with a mean age of 41 years old). Hemocirculation of the tumor was exceedingly higher than that of the contralateral gray matter, which corresponded to neuroradiological findings of abundant tumor vessels. Low rOEF implicated an excessive blood flow beyond oxygen demand of the tumor. The raised metabolic rate (rCMRO2/rCMRGl) suggested rather aerobic glycolysis as compared with malignant gliomas. The kinetic rate constants of tracer transport from blood to brain (k1), reverse transport from brain to blood (k2), and phosphorylation (k3) were analyzed according to the three compartment model of 18F-fluorodeoxyglucose (FDG). Tumor k1 and k2 values markedly increased in all examined cases, suggesting high permeability due to lack of blood-brain barrier and an abundant blood supply.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Evaluation of partial volume effect in quantitative measurement of regional cerebral blood flow in single photon emission computed tomography--effects of limited spatial resolution and first-pass extraction fraction].

Two numerical brain phantoms were generated in order to investigate errors which might be included in the quantitative measurement of regional CBF with use of single photon emission computed tomography (SPECT). The first phantom simulated the normal brain, and effects of the limited spatial resolution of the SPECT scanner were evaluated for 4 tracer kinetic models of the conventional microsphere model, the intra-carotid bolus injection technique of 133Xe, 133Xe Kanno-Lassen method, and the IMP-autoradiography (IMP-ARG) method. The second phantom simulated the diseased brain with middle-carotid artery (MCA) occlusion, and effects of the limited first-pass extraction fraction were investigated for the microsphere model with various permeability-surface area products. The limited spatial resolution caused systematic underestimation of the radioactivity concentration in the gray matter regions, and systematic overestimation in the low CBF regions. These errors in the original radioactivity distribution were found to cause further systematic errors in the calculated regional CBF images. It was also found that these errors were highly dependent on the tracer kinetic model employed, e.g., regional CBF values were overestimated in the clearance and the Kanno-Lassen methods compared with the conventional microsphere method, whereas values were underestimated in the IMP-ARG method. It was also shown in this study that the limited first-pass extraction fraction caused significant underestimation in the calculated rCBF values. In addition, regional contrast can be reduced when using a tracer with small PS product.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain↗

[Evaluation of partial volume effect in quantitative measurement of regional cerebral blood flow using positron emission tomography].

Effects of limited spatial resolution of the positron emission tomography (PET) scanner on the quantitative measurement of regional cerebral blood flow (rCBF) was investigated for various tracer kinetic models with use of 15O labeled water and PET. Using a numerical brain phantom consisting of a gray matter, white matter and cerebrospinal fluid components, dynamical tracer distribution images were calculated for the H215O bolus injection and for the C15O2 gas inhalation protocols. The tracer distribution images were convoluted with a 2 dimensional gaussian function with full-width at half maximum (FWHM) of 4, 7, 12 mm to simulate a limited spatial resolution of the PET scanner, and rCBF images were calculated according to some kinetic models. Smoothing the tracer distribution images caused a heterogeneous structure (tissue mixture) in a given volume element. rCBF values calculated by models with use of 15O-water and PET were found to provide rCBF values that were systematically underestimated compared with those obtained by the microsphere model for a mixed tissue region. Moreover, the magnitude of the underestimation was shown to be highly dependent on the tracer kinetic models employed, those errors for mixed tissue of gray and white matter were 20% on steady state, 9% on autoradiography and on weighted integration method, and 2% on non-linear least squares fitting, compared with microsphere model. More errors observed by steady state method and autoradiography method happened for tissue mixture consisting gray matter, white matter and cerebrospinal fluid components. It is important to take into account for difference of the partial volume effect for each models in calculated rCBF.

Brain↗

[Positron emission tomographic findings of subependymal giant cell astrocytoma developed in tuberous sclerosis--a case report].

Tuberous sclerosis (TS) is well known to be occasionally associated with subependymal giant cell astrocytoma (SGCA). SGCA is considered to be a benign tumor in its clinical course and morphology. However, this tumor is grown sometimes so rapid and caused hydrocephalus. To our knowledge, little is known about hemocirculation and metabolism, particularly in relation with proliferating activity of TS and SGCA. We measured hemocirculation and metabolism of SGCA developed in a case of TS using positron emission tomography (PET). A 13-year-old-boy who had frequently developed convulsions four months after birth. He was diagnosed as TS and had been medically treated with anticonvulsants, since multiple intraventricular calcifications were detected by CT, at the age of five months. The convulsions had been well controlled. In March 1993, he presented with syncopal attack and admitted to our hospital. CT showed multiple subependymal nodules. Among the nodules, one of the left anterior horn exceeded 2cm in size obliterated Monro's foramen. The tumor was homogeneously enhanced with contrast medium. The lesion detected by postcontrast T1-weighted MR imaging had almost the same status as that by CT. T2-weighted image revealed cortical tubers as high intensity area at the left frontal and parietooccipital regions. PET was performed with the Headtome IV. Hemocirculation of the tumor was lower than that of contralateral gray matter, which suggested poor blood supply. The oxygen and glucose metabolism of the tumor were decreased compared with contralateral gray matter, indicative of a low activity of proliferation and a clinically benign tumor in the present case.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Aging effect on neutral amino acid transport at the blood-brain barrier measured with L-[2-18F]-fluorophenylalanine and PET.

UNLABELLED: Neutral amino acids (NAAs) are transported from the blood to the brain using the same carrier system in a competitive fashion. The purpose of this study is to establish a method for evaluating neutral amino acid transport at the blood-brain barrier (BBB) in humans and to examine the aging effect of amino acid transport. METHODS: A dynamic PET study with L-(2-18F)-fluorophenylalanine (18F-Phe) was performed in 14 normal volunteers (age 21-71 yr; mean +/- s.d., age range 48.0 +/- 17.1 yr). By using a two-compartment model analysis and a weighted integration technique, the influx rate constant K1, the efflux rate constant k2 and distribution volume Vd of 18F-Phe were estimated in various brain structures. RESULTS: The value of K1 was inversely correlated with plasma NAA concentration (r = -0.69, p < 0.01). The cerebellum showed the highest value of K1, while the white matter showed the lowest. There was no significant change in K1 during aging. The value of k2 was significantly increased with age. CONCLUSION: No decline of K1 during aging indicated that NAA transport from the blood to the brain is a limiting process of age in amino acid incorporation. Fluorine-18-Phe PET imaging is a feasible method to study NAA transport at the BBB in vivo in humans and can be applied to pathological conditions of the brain.

Adult↗

Evaluation of cerebral infarction with iodine 123-iomazenil SPECT.

UNLABELLED: This study evaluates ischemic damage to central benzodiazepine (BZD) receptor binding in the brain with [123]iomazenil SPECT in relation to CT hypodense lesions and blood flow abnormalities. METHODS: Nine patients with middle cerebral artery territory infarction were studied. Iomazenil images obtained 180 min postinjection were analyzed for BZD receptor binding. The cortical infraction, visualized as CT hypodense area on CT, the peri-infarct area, visualized as normodensity surrounding the infarction on CT, the intrahemispheric remote area and the cerebellum were analyzed by taking the ratio of the lesion to contralateral mirror region (L/C ratio). CT during the chronic stage and perfusion images obtained during the smallest time difference between the two studies were used for comparative analysis. RESULTS: The mean L/C ratio of iomazenil uptake was 0.53 +/_ 0.08, 0.79 +/- 0.07, 0.98 +/- 0.03 and 1.00 +/- 0.04 in the infarct, peri-infarct and remote areas and the cerebellum, respectively. The infarct and peri-infarct areas showed significant decrease compared with unity. The corresponding mean L/C ratio for blood flow was 0.52 +/- 0.08, 0.73 +/- 0.07, 0.83 +/- 0.09, and 0.80 +/- 0.07, respectively. In all areas, the ratios were significantly decreased compared with unity. There was significant difference between the L/C ratio for blood flow and iomazenil in the remote area and the cerebellum. CONCLUSION: Iodine-123-iomazenil SPECT imaging may provide new information on ischemic damage to the brain, particularly neurons.

Aphasia, Broca↗

Carbon-11-methionine PET evaluation of intracerebral hematoma: distinguishing neoplastic from non-neoplastic hematoma.

UNLABELLED: We evaluated whether PET with L-methyl-11C-methionine (11C-methionine) was clinically useful in distinguishing neoplastic from non-neoplastic intracerebral hematoma. METHODS: We examined eight patients with neoplastic (n = 4) or non-neoplastic (n = 4) intracerebral hematomas between 5 and 68 days after the bleeding episode using PET with 11C-methionine (Met-PET). RESULTS: Carbon-11-methionine accumulated in the area surrounding the hematoma in both groups, except in one patient with an acute hypertensive hematoma. Between 22 and 45 days after the ictus, non-neoplastic hematomas showed increased 11C-methionine accumulation largely in accordance with the contrast-enhanced areas on CT or MR images; whereas between 14 and 68 days after bleeding, neoplastic hematomas showed increased 11C-methionine accumulation that extended beyond the contrast-enhanced areas on CT or MR images. The intensity of 11C-methionine accumulation in tumor tissue was greater than that in non-neoplastic hematomas. CONCLUSION: Preliminary results suggest that Met-PET can distinguish neoplastic from non-neoplastic hematomas on the basis of differences in lesion extent compared with CT or MR findings.

Adult↗

Perfusion and metabolism in predicting the survival of patients with cerebral gliomas.

BACKGROUND: Noninvasive measurements of cerebral circulation and metabolism may be useful for diagnosis in patients with brain tumors. The authors tested the prognostic significance of circulatory and metabolic values or ratios determined by positron emission tomography (PET) in patients with gliomas. METHODS: The subjects were 23 patients, who underwent a complete PET study of cerebral circulation and metabolism with long-term follow-up of at least 57 months. Regional cerebral blood flow (rCBF), blood volume (rCBV), oxygen extraction fraction, and the metabolic rates of oxygen (rCMRO2) and glucose (rCMRGl) were measured before treatment. Data regarding tumors, the contralateral gray matter and white matter, and the ratio between tumor and gray matter or between tumor and white matter were compared with survival time from the time of the PET study. Prognostic factors were tested using Cox's regression analysis. RESULTS: Among clinical parameters, histologic grade and performance status were important variables regulating survival. When survival times of patients with values or ratios equal to or higher than the median were compared to those of patients with values or ratios lower than the median, significant determinant PET measurements were tumor rCMRGl and the ratios of tumor:gray rCMRGl and tumor:white rCMRGl. Median survival time in the patients with an rCMRGl value of 4.4 mg/100ml/minute (median value) or more indicated 9 months, which was significantly shorter than greater than 113 months in the patients with a value lower than the median (P = 0.003 by the generalized Wilcoxon test). Patients with a higher value of gray rCBF, rCBV, or rCMRO2 had significantly longer survival times than those with a lower value. CONCLUSIONS: Cerebral circulation and metabolism as determined by PET can be of ancillary significance in predicting the prognosis of patients with gliomas.

Adolescent↗

Accumulation of L-[2-(F-18)]fluorophenylalanine in peri-infarct area in a patient with acute cerebral infarction.

We studied the brain uptake of amino acid in a patient with acute cerebral infarction with L-[2-(F-18)]fluorophenylalanine and positron emission tomography. The increased accumulation of the ligand was specifically found in the peri-infarct area where oxygen metabolism was still maintained but decreased later in the 72-day follow-up period. The kinetic analysis revealed that increased accumulation was not due to increased transport from the blood to the brain but delayed washout from the brain to the blood. Although the mechanism is still unknown, abnormally high accumulation of L-[F-18]fluorophenylalanine may predict delayed neuronal changes after ischemic insults of the brain.

Aged↗

Assessment of dopamine metabolism in brain of patients with dementia by means of 18F-fluorodopa and PET.

By means of positron emission tomography (PET) and 18F-fluorodopa (FDOPA), a study was initiated to analyze the cerebral dopamine (DA) metabolism of 32 subjects including those with AD/SDAT and vascular dementia (VD, multi-infarct type). A semiautomated irregular ROI drawing routine to identify the striatum was developed that interactively defined the PET threshold pixels referring to the count histograms and location of the corresponding pixels. A comparative study by five examiners showed significant improvement in the area size definition and count linearity particularly for low contrast objects. The graphical plot was employed to calculate the FDOPA influx rate (Ki) for the ROI data with cerebellar radioactivity as an input function. The striatal Ki value was found to be relatively stable and did not show signs of a significant age-related change. The vascular patients had smaller Ki to the striatum than the aged control. Although the mean Ki of AD/SDAT was almost compatible with that of age-matched normals, their Ki was more scattered with higher and lower Ki cases. The multiple regression analysis revealed that the Ki could be predicted by age and the mini-mental state (MMS) performance (r2 = 0.590, p < 0.01 for AD/SDAT, r2 = 0.401, and p < 0.05 for VD). MMS was found to be a more dominant factor than age. We conclude that dopamine metabolism became disturbed as dementia became progressively severe.

Aged↗

Evolution of crossed cerebellar diaschisis in middle cerebral artery infarction.

To elucidate the evolution of crossed cerebellar diaschisis, cerebral oxygen metabolism was measured repeatedly by positron emission tomography (PET) in 35 consecutive patients with unilateral cerebral infarction within the territory of middle cerebral artery. The crossed cerebellar diaschisis was defined as significant when the laterality ratio of cerebral oxygen metabolism between the left and right cerebellar hemispheres exceeded the control range (mean +/- 2 standard deviations) as derived from 27 age-matched normal volunteers. Significant crossed cerebellar diaschisis was observed in 31 patients (89%) on the initial PET studies. Of these 31 patients, 23 with infarcts involving the frontal sensorimotor cortex persistently had crossed cerebellar diaschisis up to 5 years after onset, whereas the diaschisis disappeared in 8 patients with smaller infarcts mainly in the frontal or parietal lobe without recovery of oxygen metabolism in the infarcted areas. These present results suggest that crossed cerebellar diaschisis can exist persistently even in the late stage in those having a lesion involving the cortical pontine-cerebellar pathways.

Cerebellum↗

Methionine PET for follow-up of radiation therapy of primary lymphoma of the brain.

Positron emission tomography (PET) with carbon-11 methionine, computed tomography (CT), and magnetic resonance (MR) imaging were performed in 10 patients with histologically verified central nervous system (CNS) lymphoma before and after radiation therapy to compare the radiologic findings and to evaluate the usefulness of PET in monitoring tumor response to radiation therapy. Methionine PET clearly depicted CNS lymphoma before radiation therapy as an increased accumulation of C-11 methionine. The extent of increased accumulation of the radiotracer in tumor tissue markedly decreased after radiation therapy. The area of increased uptake was larger than the enhancing lesions on CT or MR images in most cases. One patient was confirmed to have tumor recurrence at the region of residual increased accumulation on methionine PET images. Methionine PET is useful for the delineation of CNS lymphoma and for monitoring the therapeutic effect of irradiation.

Aged↗

Comparison of carbon dioxide responsiveness of cerebellar blood flow between affected and unaffected sides with crossed cerebellar diaschisis.

BACKGROUND AND PURPOSE: Concerning vasoreactivity of cerebellar blood flow (CeBF) in patients affected with crossed cerebellar diaschisis (CCD), several controversies have been reported. One is reduced asymmetry of CeBF after acetazolamide administration in 99mTc hexamethylpropyleneamine oxime single-photon emission-computed tomography, and the other is persistent asymmetry with alternation in PaCO2 using the 133Xe clearance method. The purpose of this study is to examine whether CeBF vasoreactivity in the side affected with CCD is the same as that in the unaffected side. METHODS: We analyzed CeBF during hypocapnia, normocapnia, and hypercapnia performed in 27 patients with cerebrovascular disease (age range, 38 to 73 years; mean age, 62.0 +/- 8.5 years) affected by CCD. CeBF was measured using H2(15)O and positron emission tomography. RESULTS: The CeBF ratio of CCD-affected side to CCD-unaffected side was consistent during the perturbation of PaCO2. This ratio was 0.82 +/- 0.08 for PaCO2 elevation and 0.83 +/- 0.07 for PaCO2 lowering. Both were not significantly different from unity. CONCLUSIONS: The percent change of CeBF per millimeter of mercury PaCO2 change was uniform across affected and unaffected sides with CCD. These findings are consistent with our recent findings observed in activated cerebral tissue during photic stimulation.

Adult↗

[Circulation time determined by carotid angiography in patients with chronic internal carotid artery occlusion: comparison with cerebral blood flow and oxygen metabolism measured by PET].

The degree of collateral circulation in patients with unilaterally chronic internal carotid artery occlusion was estimated by mean transit time of contrast material in rapid sequence carotid angiography (Angiographic MTT), and compared with cerebral blood flow and oxygen metabolism measured by PET. In normal density region on X-ray CT, a significant negative correlation was observed between Angiographic MTT and cerebral blood flow (CBF). This indicates that cerebral blood flow can be estimated by Angiographic MTT. It has been reported that the ratio of cerebral blood volume (CBV) to CBF (CBV/CBF), i.e., mean transit time determined by PET well agreed with OEF, and is good indicator for brain circulation reserve. In this study, no significant correlation was observed between Angiographic MTT and CBV/CBF. However, a significant positive correlation was observed between Angiographic MTT and oxygen extraction fraction (OEF), and no significant correlation was observed between Angiographic MTT and oxygen consumption rate (CMRO2). These indicates that Angiographic MTT may be indicator for brain circulation reserve.

Aged↗