Applicability of emission-based attenuation map for rapid CBF, OEF, and CMRO2 measurements using gaseous 15O-labeled compounds

Cerebral blood flow (CBF), oxygen extraction fraction (OEF), and cerebral metabolic rate of oxygen (CMRO2) images have facilitated understanding of the pathophysiological basis of cerebrovascular disorders. Such parametric images can be rapidly, measured within around 15 min, using positron emission tomography (PET) with sequentially administered 15O-labeled oxygen and water. For further shortening, one option is to eliminate the transmission scan by applying an emission-based attenuation correction. The validity of the present method was tested by comparing parametric values with emission-based attenuation correction to those with transmission-based correction. This was applied to 27 subjects who were diagnosed with or without cerebrovascular disorders. All subjects received the rapid CBF/OEF/CMRO2 PET measurements. An emission-based attenuation map was generated by estimating the edge of the brain tissue contour on an obtained sinogram and by assuming the uniform tissue coefficient to be 0.1 cm−1. Then images were reconstructed, and parametric images were computed. No difference was apparent between the emission- and transmission-based methods. Paired t-test showed no significant differences in CBF, OEF, or CMRO2 values between the emission- and transmission-based methods, except in the parietal and occipital and cerebellum and occipital regions, and the differences were less than 10%. The regression analysis showed a close correlation of r = 0.89 to 0.99. The present study revealed that the attenuation correction can be performed by the emission-based estimation method and clinical PET duration can be shortened for the CBF, OEF, and CMRO2 gas study.