Co-55-PET in stroke: relation to bloodflow, oxygen metabolism and gadolinium-MRI

H Stevens, HML Jansen, J DeReuck, M Lemmerling, K Strijckmans, P Goethals, [No Value] Lemahieu, BM DeJong, ATM Willemsen, J Korf

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Abstract

BACKGROUND: Several studies have shown the feasibility of Co-isotopes (Co-55 and Co-57) in imaging of neuronal damage in stroke, multiple sclerosis, cerebral tumors and trauma. These studies indicate that Co-isotopes allow visualization of brain pathology related to inflammatory processes, reactive gliosis and cell death. Until now, it is not clear if Co-55 accumulation occurs in the core of infarction or in the penumbra. Therefore, in the present study, we compared Co-55-PET with functional parameter such as cerebral bloodflow (rCBF) using (CO2)-O-15, oxygen metabolism (rCMRO(2)) using O-15(2) and cerebral bloodvolume (CBV) using (CO)-O-15 in PET and with the anatomical parameter Gd-MRI.

PATIENTS AND METHODS: Seventeen patients (11 male; 6 female) age 43 to 84 (mean 69) with middle cerebral artery (mca) stroke, as proven by CT or MRI, were examined with Co-55-PET (0.5-1.0 mCi (CoCl2)-Co-55), (CO2)-O-15-, O-15(2)- and (CO)-O-15-PET in one session 0-30 days after stroke-onset. Regions of infarction were defined by rCMRO(2) being smaller than 65% or rCBF below 45% of the contralateral value and were subsequently superimposed on the cobalt scan. To compare the Cobalt uptake with the Gd-MRI, a realignment program was used that matches the MRI with the blood-flow images. Clinical status was established using the Orgogozo stroke scale at admission and at discharge (at least 6 weeks after admission) and the Barthel index.

RESULTS: Eight patients showed a positive Co-PET scan and were used for further analysis. It appeared that Co accumulates in areas with a diminished oxygen metabolism and with a preserved bloodflow. We found Co-uptake in only a part of the Gd enhanced brain tissue with a tendency to be located peripherally or outside the Gd demarcated brain tissue.

CONCLUSION: The results of the present study suggest that Co accumulates into infarcted brain tissue with a rather preserved flow independently of blood-brain barrier breakdown.

Original languageEnglish
Pages (from-to)172-177
Number of pages6
JournalActa neurologica belgica
Volume97
Issue number3
Publication statusPublished - Sep-1997
EventInternational Symposium on Nuclear Medicine and Clinical Neurology - , Belgium
Duration: 7-Mar-19978-Mar-1997

Keywords

  • POSITRON EMISSION TOMOGRAPHY
  • PROGRESSIVE MULTIPLE-SCLEROSIS
  • TRAUMATIC BRAIN INJURY
  • ACUTE ISCHEMIC STROKE
  • CALCIUM
  • NEURONS
  • TISSUE

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