Technical notes| Volume 30, ISSUE 4, P513-520, June 2014

Development of an automatic ROI setting program for input function determination in 99mTc-ECD non-invasive cerebral blood flow quantification

Published:February 03, 2014DOI:


      Non-invasive quantitative measurements are useful for clinical study as these are simple and pain-free procedures. A new non-invasive semi-automatic quantitative measurement method, the improved brain uptake ratio (IBUR) method using 99mTc-ECD SPECT, has recently been reported. If an automatic ROI setting algorithm could be developed to determine the input function for the IBUR method, analysis of regional cerebral blood flow (rCBF) can be completed within a few min without recourse to complex techniques, through a fully automatic rCBF analysis program. The purpose of this study was to develop an automatic input function determination program for 99mTc-ECD non-invasive cerebral blood flow quantification and to confirm the feasibility of use of this program.
      The images of 15 consecutive patients who underwent both 99mTc-ECD chest RI angiography and SPECT examinations were used for development of the automatic arterial input function program. The images of 69 consecutive patients were used for validation of the program.
      The coincidence ratio between the ROI automatic method and the manual setting method was 98%. The mean difference in the ROI location was ±6.4 mm in the X direction and ±8.6 mm in the Y direction. Individual rCBF values obtained using these independent techniques were also reasonably well correlated (r = 0.95). The total time for the IBUR analysis using the automatic method is 2–3 min as compared to 20–30 min for the current analysis method. This technique improves the throughput of nuclear medical examinations.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Physica Medica: European Journal of Medical Physics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Okazawa H.
        • Kudo T.
        Clinical impact of hemodynamic parameter measurement for cerebrovascular disease using positron emission tomography and 15O-labeled tracer.
        Ann Nucl Med. 2009; 23: 217-227
        • Inui Y.
        • Toyama H.
        • Manabe Y.
        • Sato T.
        • Sarai M.
        • Kosaka K.
        • et al.
        Evaluation of probable or possible dementia with lewy bodies using 123I-IMP brain perfusion SPECT, 123I-MIBG, and 99mTc-MIBImyocardial SPECT.
        J Nucl Med. 2007; 48: 1641-1650
        • Wong C.H.
        • Mohamed A.
        • Larcos G.
        • McCredie R.
        • Somerville E.
        • Bleasel A.
        Brain activation patterns of versive, hypermotor, and bilateral asymmetric tonic seizures.
        Epilepsia. 2010; 51: 2131-2139
        • Newberg A.B.
        • Wintering N.
        • Khalsa D.S.
        • Roggenkamp H.
        • Waldman M.R.
        Meditation effects on cognitive function and cerebral blood flow in subjects with memory loss: a preliminary study.
        J Alzheimers Dis. 2010; 20: 517-526
        • Kaminaga T.
        • Kunimatsu N.
        • Chikamatsu T.
        • Furui S.
        Validation of CBF measurement with non-invasive microsphere method (NIMS) compared with autoradiography method (ARG).
        Ann Nucl Med. 2001; 15: 61-64
        • Tomiguchi S.
        • Tashiro K.
        • Shiraishi S.
        • Yoshida M.
        • Kawanaka K.
        • Takahashi Y.
        • et al.
        Estimation of 123I-IMP arterial blood activity from dynamic planar imaging of the chest using a graph plot method for the quantification of regional cerebral blood flow.
        Ann Nucl Med. 2010; 24: 387-393
        • Matsuda H.
        • Tsuji S.
        • Shuke N.
        • Sumiya H.
        • Tonami N.
        • Hisada K.
        Noninvasive measurements of regional cerebral blood flow using technetium-99m hexamethylpropylene amine oxime.
        Eur J Nucl Med. 1993; 20: 391-401
        • Matsuda H.
        • Yagishita A.
        • Tsuji S.
        • Hisada K.
        A quantitative approach to technetium-99m ethyl cysteinate dimmer: a comparison with technetium-99m hexamethyl propylene amine oxime.
        Eur J Nucl Med. 1995; 22: 633-637
        • Abe S.
        • Kato K.
        • Takahashi Y.
        • Fujita N.
        • Yamashita M.
        • Shinoda M.
        • et al.
        Estimation of 123I-IMP arterial blood activity using 123I-IMP acquisition data from the lungs and brain without any blood sampling: validation of its usefulness for quantification of regional cerebral blood flow.
        Clin Nucl Med. 2012 Mar; 37: 258-263
        • Miyazaki Y.
        • Kinuya S.
        • Hashimoto M.
        • Satake R.
        • Inoue H.
        • Shio- zaki J.
        • et al.
        Brain uptake ratio as an index of cerebral blood flow obtained with 99mTc-ECD.
        Kaku Igaku. 1997; 34 ([in Japanese]): 49-52
        • Ito S.
        • Tkaki A.
        • Inoue S.
        • Tomiguchi S.
        • Shiraisgi S.
        • Akiyama Y.
        • et al.
        Improvement of the 99mTc-ECD brain uptake ratio (BUR) method for measurement of cerebral blood flow.
        Ann Nucl Med. 2012; 26: 351-358
        • Inoue S.
        • Kabuto T.
        • Masunaga S.
        • Souma T.
        • Takaki A.
        • Hosoya T.
        • et al.
        Determination of the optimal ROI setting position of the input function for the 99mTc-ethyl cysteinate dimmer brain uptake ratio method.
        Nihon Hoshasen Gijutsu Gakkai Zasshi. 2012; 68 ([Japanese]): 269-276
        • Takeuchi R.
        • Yonekura Y.
        • Matsuda H.
        • Konishi J.
        Usefulness of a three-dimensional stereotaxic ROI template on anatomically standardised 99mTc-ECD SPET.
        Eur J Nucl Med Mol Imaging. 2002; 29: 331-341