A Study on the Extraction Rate of Brain Tissues from a $^{99m}Tc$-HMPAO Cerebral Blood flow SPECT Examination of a Patient

$^{99m}Tc$-HMPAO 뇌혈류 SPECT 검사 시 환자에 따른 뇌조직 추출률에 대한 고찰

  • Kim, Hwa-San (Department of Nuclear Medicine, The Catholic University of Korea. Bucheon ST. Mari's Hospital) ;
  • Lee, Dong-Ho (Department of Nuclear Medicine, The Catholic University of Korea. Bucheon ST. Mari's Hospital) ;
  • Ahn, Byeong-Pil (Department of Nuclear Medicine, The Catholic University of Korea. Bucheon ST. Mari's Hospital) ;
  • Kim, Hyun-Ki (Department of Nuclear Medicine, The Catholic University of Korea. Bucheon ST. Mari's Hospital) ;
  • Jung, Jin-Yung (Department of Nuclear Medicine, The Catholic University of Korea. Bucheon ST. Mari's Hospital) ;
  • Lee, Hyung-Nam (Department of Nuclear Medicine, The Catholic University of Korea. Bucheon ST. Mari's Hospital) ;
  • Kim, Jung-Ho (Department of Nuclear Medicine, The Catholic University College of Medicine of Korea. Bucheon ST. Mari's Hospital)
  • 김화산 (가톨릭 대학교 부천성모병원 핵의학팀) ;
  • 이동호 (가톨릭 대학교 부천성모병원 핵의학팀) ;
  • 안병필 (가톨릭 대학교 부천성모병원 핵의학팀) ;
  • 김현기 (가톨릭 대학교 부천성모병원 핵의학팀) ;
  • 정진영 (가톨릭 대학교 부천성모병원 핵의학팀) ;
  • 이형남 (가톨릭 대학교 부천성모병원 핵의학팀) ;
  • 김정호 (가톨릭 대학교 부천성모병원 핵의학교실)
  • Received : 2012.02.28
  • Accepted : 2012.04.06
  • Published : 2012.04.28

Abstract

Purpose: This study mainly focuses on the patients treated with chemically stable radiopharmaceutical product $^{99m}Tc$-HMPAO (d,l-hexamethylpropylene amine oxime) which yielded reduced image quality due to a decreased brain extraction rate. $^{99m}Tc$-HMPAO will be examined further to determine whether this product may be accounted as a factor for this cause. Material and Methods: From January 2010 until December 2010, out of 272 patients who were all subjected to $^{99m}Tc$-HMPAO brain blood flow SPECT scans resulting from Cerebral Infarction; 23 patients(ages $55.3{\pm}9$, 21 males, 3 females) with decreased tissue extraction rate were examined in detail. The radiopharmaceutical product $^{99m}Tc$-HMPAO was used on patients with normal brain tissue exchange rate as well as those with reduced rate in order to prove its' chemical stability. The patients' age, sex, blood pressure, existence of diabetes, drug use, current health status, known side effects from CT/MRI, examination of the patients' past SPECT before/after images were accounted to determine the factors and correlations affecting the rate of blood tissue extractions. Result: After multiple linear regression analysis, there were no unusual correlations between the 6 factors excluding sex, and before/after examination images. Male subjects showed reduced brain tissue extraction rate than the females ($p$ > 0.05) 91.3% male, 8.7% female. Wilcoxon Matched-Pairs Signed-Ranks Test was used on the before/after images which yielded a value of 0.06, which did not indicate a significant amount of difference on the 2 tests ($p$ > 0.05). As a result, the before/after images indicated similar brain tissue extraction rates, and there were variations depending on the individual patient. Conclusion: The effects of the chemically stable radiopharmaceutical product $^{99m}Tc$-HMPAO depended on the patient's personal characteristics and status, therefore was considered to be a factor in reducing brain tissue extraction rate. The related articles of $^{99m}Tc$-HMPAO cerebral blood flow SPECT speculates a cerebrovascular disease and factors resulting from portal veins, and it was not possible to pin point the exact cause of decreasing brain tissue extraction rate. However, the $^{99m}Tc$-HMPAO cerebral blood flow SPECT scan proved to be extremely useful in tracking and inspecting brain diseases, as well as offering accurate results from patients suffering from reduced brain tissue extraction rates.