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November 11, 1988, Vol 260, No. 18 >
ARTICLE | November 11, 1988

Positron Emission Tomography—A New Approach to Brain Chemistry FREE

[+] Author Affiliations

Presented to the American Medical Association House of Delegates at the 1987 Annual Meeting as an informational report.

This report is not intended to be construed or to serve as a standard of medical care. Standards of medical care are determined on the basis of all of the facts and circumstances involved in an individual case and are subject to change as scientific knowledge and technology advance and patterns of practice evolve. This report reflects the views of scientific literature as of February 1987.

Reprint requests to the Council on Scientific Affairs, American Medical Association, 535 N Dearborn St, Chicago, IL 60610 (William R. Hendee, PhD).


JAMA. 1988;260(18):2704-2710. doi:10.1001/jama.1988.03410180112041
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Article
References

Positron emission tomography permits examination of the chemistry of the brain in living human beings. Until recently, positron emission tomography had been considered a research tool, but it is rapidly moving into clinical practice. This report describes the uses and applications of positron emission tomography in examinations of patients with strokes, epilepsy, malignancies, dementias, and schizophrenia and in basic studies of synaptic neurotransmission.

(JAMA 1988;260:2704-2710)

REFERENCES

1 +
Kuhl DE, Engel J Jr, Phelps ME, et al:  Epileptic patterns of local cerebral metabolism and perfusion in humans determined by emission computed tomography of FDG and NH3 . Ann Neurol 1980;;8:348-360.
2 +
Engel J Jr, Kuhl DE, Phelps ME:  Patterns of human local cerebral glucose metabolism during epileptic seizures . Science 1982;;218:64-66.
3 +
Engel J Jr, Kuhl DE, Phelps ME, et al:  Interictal cerebral glucose metabolism in partial epilepsy and its relation to EEG changes . Ann Neurol 1982;;12:510-517.
4 +
Engel J Jr, Kuhl DE, Phelps ME:  Regional brain metabolism during seizures in humans . Adv Neurol 1983;;34:141-148.
5 +
Engel J Jr, Kuhl DE, Phelps ME, et al:  Comparative localization of epileptic foci in partial epilepsy by PCT and EEG . Ann Neurol 1982;;12:529-537.
6 +
Engel J Jr, Ackermann RF, Kuhl DE, et al:  Brain imaging of glucose utilization in convulsive disorders , in Sokoloff L (ed): Brain Imaging and Brain Function . New York, Raven Press, 1985;, vol 63, pp 163-184.
7 +
Theodore WH, Brooks R, Margolin R, et al:  Positron emission tomography in generalized seizures . Neurology 1985;;35:684-690.
8 +
Theodore WH, Dowart R, Holmes H, et al:  Neuroimaging in refractory partial seizures: Comparison of PET, OT, and MRI . Neurology 1986;;36:60-64.
9 +
Bernardi S, Trimble MR, Frackowiak RS, et al:  An interictal study of partial epilepsy using positron emission tomography and the oxygen-15 inhalation technique . J Neurol Neurosurg Psych 1983;;46:473-477.
10 +
Chugani T, Engel J Jr, Mazziotta JC, et al:  18F-2-fluorodeoxyglucose positron emission tomography in medically refractory childhood epilepsy . Neurology 1984;;34( (suppl 1) ):107.
11 +
Engel J Jr, Rausch R, Lieb JP, et al:  Correlation of criteria used for localizing epileptic foci in patients considered for surgical therapy of epilepsy . Ann Neurol 1981;;9:215-224.
12 +
Engel J Jr, Kuhl DE, Phelps ME, et al:  Local cerebral metabolism during partial seizures . Neurology 1983;;33:400-413.
13 +
Engel J Jr, Lubens P, Kuhl DE, et al:  Local cerebral metabolic rate for glucose during petit mal absences . Ann Neurol 1985;;17:121-128.
14 +
Gur RC, Sussman NM, Alavi A, et al:  Positron emission tomography in two cases of childhood epileptic encephalopathy (Lennox-Gastaut syndrome) . Neurology 1982;;32:1191-1194.
15 +
Kuhl DE, Engel J, Phelps ME:  Emission computed tomography of FDG and NH3 in partial epilepsy , in Moosy J, Reinmuth OM (eds): Cerebrovascular Diseases: 12th (Princeton) Conference . New York, Raven Press, 1981;, pp 73-76.
16 +
Kuhl DE, Engel J Jr, Phelps ME:  Emission computed tomography in the study of human epilepsy , in Ward AA Jr, Penry JK, Purpura D (eds): Epilepsy . New York, Raven Press, 1983;, pp 327-340.
17 +
Kuhl DE:  Annual oration 1982: Imaging local brain function with emission computed tomography . Radiology 1984;;150:625-631.
18 +
Mazziotta JC, Engel J Jr:  The use and impact of PET scanning in epilepsy . Epilepsia 1984;;25( (suppl 2) ):S86-S104.
19 +
Newmark HE, Theodore W, DeLaPaz R, et al:  Positron emission tomography in refractory complex partial seizures . Ann Neurol 1981;;10:73-74.
20 +
Ochs RF, Yamamoto YL, Gloor P, et al:  Correlation between the PET measurement of glucose metabolism and oxygen utilization with focal epilepsy . Neurology 1984;;34:( (suppl 1) ):125.
21 +
Sperling MR, Engel J Jr, Bradley W, et al:  MRI, PET, and CT in complex partial epilepsy . Epilepsia 1985;;26:534-535.
22 +
Szelies B, Herholz K, Heiss WD, et al:  Hypometabolic cortical lesions in tuberous sclerosis with epilepsy: Demonstration by positron emission tomography . J Comput Assist Tomogr 1983;;7:946-953.
23 +
Theodore H, Newmark ME, Sato S, et al:  18-F-fluorodeoxyglucose positron emission computed tomography in refractory complex partial seizures . Ann Neurol 1983;;13:419-428.
24 +
Theodore WH, Brooks R, Sata S, et al:  The role of positron emission tomography in the evaluation of seizure disorders . Neurology 1984;;15:( (suppl) ): S176-S179.
25 +
Theodore WH, Holmes MD, Dorwart RH, et al:  Complex partial seizures: Cerebral structure and cerebral function . Epilepsia 1986;;17:576-582.
26 +
Devesa SS, Silberman DT:  Cancer incidence and mortality trends in the United States: 1935-1974 . JNCI 1978;;60:645-671.
27 +
DiChiro G, DeLaPaz RL, Brooks RA, et al:  Glucose utilization of cerebral gliomas measured by 18-F-2-deoxyglucose and PET . Neurology 1982;;32: 1323-1329.
28 +
Patronas NJ, DiChiro G, Kufta C, et al:  Prediction of survival in glioma patients by means of PET . J Neurosurg 1985;;62:816-822.
29 +
Patronas NJ, DiChiro G, Brooks RA, et al:  Work in progress: 18-F-fluorodeoxyglucose and PET in the evaluation of radiation necrosis of the brain . Radiology 1982;;144:885-889.
30 +
Baron JC:  Positron tomography in cerebral ischemia: A review . Neuroradiology 1985;;27:509-516.
31 +
Frackowiak RS, Jones T, Lenzi GL, et al:  Regional cerebral oxygen utilization and blood flow in normal man using oxygen-15 and positron emission tomography . Acta Neurol Scand 1980;;62:336-344.
32 +
Lassen NA:  The luxury perfusion syndrome and its possible relation to acute metabolic acidosis localized within the brain . Lancet 1966;;2:1113-1115.
33 +
Ter-Pogossian MM, Herscovitch P:  Radioactive oxygen-15 in the study of cerebral blood flow, blood volume and oxygen metabolism . Semin Nucl Med 1985;;15:377-394.
34 +
Heiss WD, Pawlik G, Wagner R, et al:  Functional hypometabolism in non-infarcted brain regions in ischemic stroke . J Cereb Blood Flow Metab 1983;;3( (suppl 1) ):S582-S583.
35 +
Gibbs JM, Rhoades CG, Wise RJ, et al:  The relationship of regional cerebral blood flow, oxygen metabolism and glucose metabolism following acute stroke, in Heiss WD, Phelps ME (eds) : Positron Emission Tomography of the Brain . New York, Springer-Verlag NY Inc, 1983;, pp 234-235.
36 +
Gibbs JM, Wise RJS, Leenders KL, et al:  Evaluation of cerebral perfusion reserve in patients with carotid-artery occlusion . Lancet 1984;;1:310-314.
37 +
Frackowiak RSF, Wise RJ:  Positron tomography in ischemic cerebrovascular disease . Neurol Clin 1983;;1:183-200.
38 +
Ackerman RH, Alpert NM, Correia JA, et al:  Importance of monitoring metabolic function in assessing the severity of a stroke insult (CBF: An epiphenomenon?) . J Cereb Blood Flow Metab 1981;;1( (suppl 1) ):S502-S503.
39 +
Baron JC, Rougemont D, Bousser MG, et al:  Local CBF, oxygen extraction fraction (OEF) and CMR02: Prognostic value in recent supratentorial infarction in humans . J Cereb Blood Flow Metab 1983;;3( (suppl 1) ):S1-S2.
40 +
Kuhl DE, Metter EJ, Riege WH, et al:  Local cerebral glucose utilization in elderly patients with depression, multiple infarct dementia and Alzheimer's disease . J Cereb Blood Flow Metab 1983;;3( (suppl 1) ):S494-S495.
41 +
Friedland RP, Budinger TF, Ganz E, et al:  Regional cerebral metabolic alterations in dementia of the Alzheimer type: Positron emission tomography with [18F] fluorodeoxyglucose . J Comput Assist Tomogr 1983;;7:590-598.
42 +
Frackowiak RS, Pozzilli C, Legg NJ, et al:  Regional cerebral oxygen supply and utilization in dementia . Brain 1981;;104:753-778.
43 +
Foster NL, Chase TN, Mansi L, et al:  Cortical abnormalities in Alzheimer's disease . Ann Neurol 1984;;16:649-654.
44 +
Mazziotta JC:  Cerebral metabolism: Studies in normals and patients with amnesia and dementia . Ann NY Acad Sci 1985;;444:269-286.
45 +
Kuhl DE, Phelps ME, Markham CE, et al:  Cerebral metabolism and atrophy in Huntington's disease determined by FDG and computed tomographic scan . Ann Neurol 1982;;12:425-434.
46 +
Mazziotta JC, Wapenski JA, Phelps ME, et al:  Cerebral glucose metabolism and blood flow in Huntington's disease: Symptomatic and at-risk subjects . J Cereb Blood Flow Metab 1985;;5( (suppl 1) ):S25-S26.
47 +
Kuhl DE, Metter EJ, Riege WH, et al:  Patterns of cerebral glucose utilization in Parkinson's and Huntington's disease . Ann Neurol 1984;;15( (suppl) ):S119-S125.
48 +
Wagner HN Jr, Burns HD, Dannals RF, et al:  Imaging dopamine receptors in the human brain by positron tomography . Science 1983;;22:1264-1266.
49 +
Wong DF, Wagner HN Jr, Dannals RF, et al:  Effects of age on dopamine and serotonin receptors measured by positron tomography in the living human brain . Science 1984;;226:1393-1396.
50 +
Wong DF, Wagner HN Jr, Tune LE, et al:  Positron emission tomography reveals elevated D2 dopamine receptors in drug-naive schizophrenics . Science 1986;;234:1558-1563.
51 +
Farde L, Wiesel FA, Hall H, et al:  No D2 receptor increase in PET study of schizophrenia . Arch Gen Psychiatry 1987;;44:671-672.
52 +
Wong DF, Wagner HN Jr, Pearlson G, et al:  Dopamine receptor binding of C-11-NMSP in the caudate in schizophrenia and bipolar illness: A preliminary report . Psychopharmacol Bull 1985;;21:595-598.
53 +
Lee MC, Wagner HN Jr, Tanada S, et al:  Duration of occupancy of opiate receptors by naltrexone . J Nucl Med 1988;;29:1207-1211.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Kuhl DE, Engel J Jr, Phelps ME, et al:  Epileptic patterns of local cerebral metabolism and perfusion in humans determined by emission computed tomography of FDG and NH3 . Ann Neurol 1980;;8:348-360.
2 +
Engel J Jr, Kuhl DE, Phelps ME:  Patterns of human local cerebral glucose metabolism during epileptic seizures . Science 1982;;218:64-66.
3 +
Engel J Jr, Kuhl DE, Phelps ME, et al:  Interictal cerebral glucose metabolism in partial epilepsy and its relation to EEG changes . Ann Neurol 1982;;12:510-517.
4 +
Engel J Jr, Kuhl DE, Phelps ME:  Regional brain metabolism during seizures in humans . Adv Neurol 1983;;34:141-148.
5 +
Engel J Jr, Kuhl DE, Phelps ME, et al:  Comparative localization of epileptic foci in partial epilepsy by PCT and EEG . Ann Neurol 1982;;12:529-537.
6 +
Engel J Jr, Ackermann RF, Kuhl DE, et al:  Brain imaging of glucose utilization in convulsive disorders , in Sokoloff L (ed): Brain Imaging and Brain Function . New York, Raven Press, 1985;, vol 63, pp 163-184.
7 +
Theodore WH, Brooks R, Margolin R, et al:  Positron emission tomography in generalized seizures . Neurology 1985;;35:684-690.
8 +
Theodore WH, Dowart R, Holmes H, et al:  Neuroimaging in refractory partial seizures: Comparison of PET, OT, and MRI . Neurology 1986;;36:60-64.
9 +
Bernardi S, Trimble MR, Frackowiak RS, et al:  An interictal study of partial epilepsy using positron emission tomography and the oxygen-15 inhalation technique . J Neurol Neurosurg Psych 1983;;46:473-477.
10 +
Chugani T, Engel J Jr, Mazziotta JC, et al:  18F-2-fluorodeoxyglucose positron emission tomography in medically refractory childhood epilepsy . Neurology 1984;;34( (suppl 1) ):107.
11 +
Engel J Jr, Rausch R, Lieb JP, et al:  Correlation of criteria used for localizing epileptic foci in patients considered for surgical therapy of epilepsy . Ann Neurol 1981;;9:215-224.
12 +
Engel J Jr, Kuhl DE, Phelps ME, et al:  Local cerebral metabolism during partial seizures . Neurology 1983;;33:400-413.
13 +
Engel J Jr, Lubens P, Kuhl DE, et al:  Local cerebral metabolic rate for glucose during petit mal absences . Ann Neurol 1985;;17:121-128.
14 +
Gur RC, Sussman NM, Alavi A, et al:  Positron emission tomography in two cases of childhood epileptic encephalopathy (Lennox-Gastaut syndrome) . Neurology 1982;;32:1191-1194.
15 +
Kuhl DE, Engel J, Phelps ME:  Emission computed tomography of FDG and NH3 in partial epilepsy , in Moosy J, Reinmuth OM (eds): Cerebrovascular Diseases: 12th (Princeton) Conference . New York, Raven Press, 1981;, pp 73-76.
16 +
Kuhl DE, Engel J Jr, Phelps ME:  Emission computed tomography in the study of human epilepsy , in Ward AA Jr, Penry JK, Purpura D (eds): Epilepsy . New York, Raven Press, 1983;, pp 327-340.
17 +
Kuhl DE:  Annual oration 1982: Imaging local brain function with emission computed tomography . Radiology 1984;;150:625-631.
18 +
Mazziotta JC, Engel J Jr:  The use and impact of PET scanning in epilepsy . Epilepsia 1984;;25( (suppl 2) ):S86-S104.
19 +
Newmark HE, Theodore W, DeLaPaz R, et al:  Positron emission tomography in refractory complex partial seizures . Ann Neurol 1981;;10:73-74.
20 +
Ochs RF, Yamamoto YL, Gloor P, et al:  Correlation between the PET measurement of glucose metabolism and oxygen utilization with focal epilepsy . Neurology 1984;;34:( (suppl 1) ):125.
21 +
Sperling MR, Engel J Jr, Bradley W, et al:  MRI, PET, and CT in complex partial epilepsy . Epilepsia 1985;;26:534-535.
22 +
Szelies B, Herholz K, Heiss WD, et al:  Hypometabolic cortical lesions in tuberous sclerosis with epilepsy: Demonstration by positron emission tomography . J Comput Assist Tomogr 1983;;7:946-953.
23 +
Theodore H, Newmark ME, Sato S, et al:  18-F-fluorodeoxyglucose positron emission computed tomography in refractory complex partial seizures . Ann Neurol 1983;;13:419-428.
24 +
Theodore WH, Brooks R, Sata S, et al:  The role of positron emission tomography in the evaluation of seizure disorders . Neurology 1984;;15:( (suppl) ): S176-S179.
25 +
Theodore WH, Holmes MD, Dorwart RH, et al:  Complex partial seizures: Cerebral structure and cerebral function . Epilepsia 1986;;17:576-582.
26 +
Devesa SS, Silberman DT:  Cancer incidence and mortality trends in the United States: 1935-1974 . JNCI 1978;;60:645-671.
27 +
DiChiro G, DeLaPaz RL, Brooks RA, et al:  Glucose utilization of cerebral gliomas measured by 18-F-2-deoxyglucose and PET . Neurology 1982;;32: 1323-1329.
28 +
Patronas NJ, DiChiro G, Kufta C, et al:  Prediction of survival in glioma patients by means of PET . J Neurosurg 1985;;62:816-822.
29 +
Patronas NJ, DiChiro G, Brooks RA, et al:  Work in progress: 18-F-fluorodeoxyglucose and PET in the evaluation of radiation necrosis of the brain . Radiology 1982;;144:885-889.
30 +
Baron JC:  Positron tomography in cerebral ischemia: A review . Neuroradiology 1985;;27:509-516.
31 +
Frackowiak RS, Jones T, Lenzi GL, et al:  Regional cerebral oxygen utilization and blood flow in normal man using oxygen-15 and positron emission tomography . Acta Neurol Scand 1980;;62:336-344.
32 +
Lassen NA:  The luxury perfusion syndrome and its possible relation to acute metabolic acidosis localized within the brain . Lancet 1966;;2:1113-1115.
33 +
Ter-Pogossian MM, Herscovitch P:  Radioactive oxygen-15 in the study of cerebral blood flow, blood volume and oxygen metabolism . Semin Nucl Med 1985;;15:377-394.
34 +
Heiss WD, Pawlik G, Wagner R, et al:  Functional hypometabolism in non-infarcted brain regions in ischemic stroke . J Cereb Blood Flow Metab 1983;;3( (suppl 1) ):S582-S583.
35 +
Gibbs JM, Rhoades CG, Wise RJ, et al:  The relationship of regional cerebral blood flow, oxygen metabolism and glucose metabolism following acute stroke, in Heiss WD, Phelps ME (eds) : Positron Emission Tomography of the Brain . New York, Springer-Verlag NY Inc, 1983;, pp 234-235.
36 +
Gibbs JM, Wise RJS, Leenders KL, et al:  Evaluation of cerebral perfusion reserve in patients with carotid-artery occlusion . Lancet 1984;;1:310-314.
37 +
Frackowiak RSF, Wise RJ:  Positron tomography in ischemic cerebrovascular disease . Neurol Clin 1983;;1:183-200.
38 +
Ackerman RH, Alpert NM, Correia JA, et al:  Importance of monitoring metabolic function in assessing the severity of a stroke insult (CBF: An epiphenomenon?) . J Cereb Blood Flow Metab 1981;;1( (suppl 1) ):S502-S503.
39 +
Baron JC, Rougemont D, Bousser MG, et al:  Local CBF, oxygen extraction fraction (OEF) and CMR02: Prognostic value in recent supratentorial infarction in humans . J Cereb Blood Flow Metab 1983;;3( (suppl 1) ):S1-S2.
40 +
Kuhl DE, Metter EJ, Riege WH, et al:  Local cerebral glucose utilization in elderly patients with depression, multiple infarct dementia and Alzheimer's disease . J Cereb Blood Flow Metab 1983;;3( (suppl 1) ):S494-S495.
41 +
Friedland RP, Budinger TF, Ganz E, et al:  Regional cerebral metabolic alterations in dementia of the Alzheimer type: Positron emission tomography with [18F] fluorodeoxyglucose . J Comput Assist Tomogr 1983;;7:590-598.
42 +
Frackowiak RS, Pozzilli C, Legg NJ, et al:  Regional cerebral oxygen supply and utilization in dementia . Brain 1981;;104:753-778.
43 +
Foster NL, Chase TN, Mansi L, et al:  Cortical abnormalities in Alzheimer's disease . Ann Neurol 1984;;16:649-654.
44 +
Mazziotta JC:  Cerebral metabolism: Studies in normals and patients with amnesia and dementia . Ann NY Acad Sci 1985;;444:269-286.
45 +
Kuhl DE, Phelps ME, Markham CE, et al:  Cerebral metabolism and atrophy in Huntington's disease determined by FDG and computed tomographic scan . Ann Neurol 1982;;12:425-434.
46 +
Mazziotta JC, Wapenski JA, Phelps ME, et al:  Cerebral glucose metabolism and blood flow in Huntington's disease: Symptomatic and at-risk subjects . J Cereb Blood Flow Metab 1985;;5( (suppl 1) ):S25-S26.
47 +
Kuhl DE, Metter EJ, Riege WH, et al:  Patterns of cerebral glucose utilization in Parkinson's and Huntington's disease . Ann Neurol 1984;;15( (suppl) ):S119-S125.
48 +
Wagner HN Jr, Burns HD, Dannals RF, et al:  Imaging dopamine receptors in the human brain by positron tomography . Science 1983;;22:1264-1266.
49 +
Wong DF, Wagner HN Jr, Dannals RF, et al:  Effects of age on dopamine and serotonin receptors measured by positron tomography in the living human brain . Science 1984;;226:1393-1396.
50 +
Wong DF, Wagner HN Jr, Tune LE, et al:  Positron emission tomography reveals elevated D2 dopamine receptors in drug-naive schizophrenics . Science 1986;;234:1558-1563.
51 +
Farde L, Wiesel FA, Hall H, et al:  No D2 receptor increase in PET study of schizophrenia . Arch Gen Psychiatry 1987;;44:671-672.
52 +
Wong DF, Wagner HN Jr, Pearlson G, et al:  Dopamine receptor binding of C-11-NMSP in the caudate in schizophrenia and bipolar illness: A preliminary report . Psychopharmacol Bull 1985;;21:595-598.
53 +
Lee MC, Wagner HN Jr, Tanada S, et al:  Duration of occupancy of opiate receptors by naltrexone . J Nucl Med 1988;;29:1207-1211.

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