Can Internal Carotid Arteries Be Used for Noninvasive Quantification of Brain PET Studies?

J Nucl Med. 2024 Apr 1;65(4):600-606. doi: 10.2967/jnumed.123.266675.

Abstract

Because of the limited axial field of view of conventional PET scanners, the internal carotid arteries are commonly used to obtain an image-derived input function (IDIF) in quantitative brain PET. However, time-activity curves extracted from the internal carotids are prone to partial-volume effects due to the limited PET resolution. This study aimed to assess the use of the internal carotids for quantifying brain glucose metabolism before and after partial-volume correction. Methods: Dynamic [18F]FDG images were acquired on a 106-cm-long PET scanner, and quantification was performed with a 2-tissue-compartment model and Patlak analysis using an IDIF extracted from the internal carotids. An IDIF extracted from the ascending aorta was used as ground truth. Results: The internal carotid IDIF underestimated the area under the curve by 37% compared with the ascending aorta IDIF, leading to Ki values approximately 17% higher. After partial-volume correction, the mean relative Ki differences calculated with the ascending aorta and internal carotid IDIFs dropped to 7.5% and 0.05%, when using a 2-tissue-compartment model and Patlak analysis, respectively. However, microparameters (K 1, k 2, k 3) derived from the corrected internal carotid curve differed significantly from those obtained using the ascending aorta. Conclusion: These results suggest that partial-volume-corrected internal carotids may be used to estimate Ki but not kinetic microparameters. Further validation in a larger patient cohort with more variable kinetics is needed for more definitive conclusions.

Keywords: PET; cerebral glucose consumption; image-derived input function; kinetic modeling; partial-volume correction.

MeSH terms

  • Brain / metabolism
  • Carotid Arteries / diagnostic imaging
  • Carotid Artery, Internal* / diagnostic imaging
  • Carotid Artery, Internal* / metabolism
  • Fluorodeoxyglucose F18 / metabolism
  • Glucose / metabolism
  • Humans
  • Positron-Emission Tomography* / methods

Substances

  • Fluorodeoxyglucose F18
  • Glucose