Positron Emission Tomography: Basic Principles, New Applications, and Studies Under Anesthesia

Besides electroencephalography (EEG), positron emission tomography (PET) is one of the oldest tools for the exploration of the functioning brain. PET primarily focuses on neuronal activity and metabolism in the brain. It also has potential applications in studying the neurotransmitter function in the central nervous system. PET studies have laid the foundation for understanding the fundamental properties related to motor, sensory, and some cognitive functions in physiological and pathologic states. Brain function studies with PET, EEG, magnetic resonance imaging (MRI), and other neurotechnology tools have started shedding light on hitherto unknown aspects of brain function.

[1]  UnCheol Lee,et al.  Dissociable Network Properties of Anesthetic State Transitions , 2011, Anesthesiology.

[2]  K V Hansen,et al.  Regional cerebral glucose metabolism during sevoflurane anaesthesia in healthy subjects studied with positron emission tomography , 2010, Acta anaesthesiologica Scandinavica.

[3]  F. Hyder,et al.  Baseline brain energy supports the state of consciousness , 2009, Proceedings of the National Academy of Sciences.

[4]  H. Gill-Thwaites.  Lotteries, loopholes and luck: Misdiagnosis in the vegetative state patient , 2006, Brain injury.

[5]  J. Giacino,et al.  The JFK Coma Recovery Scale-Revised: measurement characteristics and diagnostic utility. , 2004, Archives of physical medicine and rehabilitation.

[6]  S. Aalto,et al.  Correlation of EEG spectral entropy with regional cerebral blood flow during sevoflurane and propofol anaesthesia * , 2005, Anaesthesia.

[7]  C. Palestro.  FDG-PET in musculoskeletal infections. , 2013, Seminars in nuclear medicine.

[8]  A. Gjedde,et al.  Effects of subanaesthetic and anaesthetic doses of sevoflurane on regional cerebral blood flow in healthy volunteers. A positron emission tomographic study , 2004, Acta anaesthesiologica Scandinavica.

[9]  M. Boly,et al.  Diagnostic accuracy of the vegetative and minimally conscious state: Clinical consensus versus standardized neurobehavioral assessment , 2009, BMC neurology.

[10]  L. Kachnic,et al.  FDG PET/CT in the management of colorectal and anal cancers. , 2014, AJR. American journal of roentgenology.

[11]  J. Giacino,et al.  The minimally conscious state: Definition and diagnostic criteria , 2002, Neurology.

[12]  Nathan S White,et al.  Impaired thalamocortical connectivity in humans during general-anesthetic-induced unconsciousness , 2003, NeuroImage.

[13]  W. Heiss.  Radionuclide Imaging in Ischemic Stroke , 2014, The Journal of Nuclear Medicine.

[14]  M. Bruno,et al.  Quantitative rates of brain glucose metabolism distinguish minimally conscious from vegetative state patients , 2014, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[15]  M. Boly,et al.  Auditory processing in severely brain injured patients: differences between the minimally conscious state and the persistent vegetative state. , 2004, Archives of neurology.

[16]  J. V. Van Horn,et al.  Functional neuroimaging of traumatic brain injury: advances and clinical utility , 2015, Neuropsychiatric disease and treatment.

[17]  S. Nekolla,et al.  Assessment of myocardial perfusion and viability by positron emission tomography. , 2013, International journal of cardiology.

[18]  Steven Laureys,et al.  From unresponsive wakefulness to minimally conscious PLUS and functional locked-in syndromes: recent advances in our understanding of disorders of consciousness , 2011, Journal of Neurology.

[19]  Steven Laureys,et al.  Perception of pain in the minimally conscious state with PET activation: an observational study , 2008, The Lancet Neurology.

[20]  A Dagher,et al.  Critical involvement of the thalamus and precuneus during restoration of consciousness with physostigmine in humans during propofol anaesthesia: a positron emission tomography study. , 2011, British journal of anaesthesia.

[21]  B. Krause,et al.  18F-FDG PET and 18F-FDG PET/CT for Assessing Response to Therapy in Esophageal Cancer , 2009, Journal of Nuclear Medicine.

[22]  N. Juul,et al.  Regional cerebral blood flow and glucose metabolism during propofol anaesthesia in healthy subjects studied with positron emission tomography , 2012, Acta anaesthesiologica Scandinavica.

[23]  W. Oyen,et al.  FDG-PET in fever of unknown origin. , 2013, Seminars in nuclear medicine.

[24]  R. Subramaniam,et al.  FDG PET/CT in patients with HIV. , 2011, AJR. American journal of roentgenology.

[25]  S Laureys,et al.  Cerebral metabolism during vegetative state and after recovery to consciousness , 1999, Journal of neurology, neurosurgery, and psychiatry.

[26]  M. Boly,et al.  Neural correlates of consciousness during general anesthesia using functional magnetic resonance imaging (fMRI). , 2012, Archives italiennes de biologie.

[27]  S. Aalto,et al.  Effects of Surgical Levels of Propofol and Sevoflurane Anesthesia on Cerebral Blood Flow in Healthy Subjects Studied with Positron Emission Tomography , 2002, Anesthesiology.

[28]  Dominick J. Laddy,et al.  Nuclear imaging: a powerful novel approach for tuberculosis. , 2014, Nuclear medicine and biology.

[29]  M. Boly,et al.  Breakdown of within- and between-network Resting State Functional Magnetic Resonance Imaging Connectivity during Propofol-induced Loss of Consciousness , 2010, Anesthesiology.

[30]  P. Erba,et al.  FDG-PET in cardiac infections. , 2013, Seminars in nuclear medicine.

[31]  Sung-Cheng Huang,et al.  In vivo characterization of chronic traumatic encephalopathy using [F-18]FDDNP PET brain imaging , 2015, Proceedings of the National Academy of Sciences.

[32]  UnCheol Lee,et al.  Disruption of Frontal–Parietal Communication by Ketamine, Propofol, and Sevoflurane , 2013, Anesthesiology.

[33]  F. Plum,et al.  Persistent vegetative state after brain damage. A syndrome in search of a name. , 1972, Lancet.

[34]  T. Carpenter,et al.  Glucose metabolism following human traumatic brain injury: methods of assessment and pathophysiological findings , 2014, Metabolic Brain Disease.

[35]  A. Dagher,et al.  PET quantification of muscarinic cholinergic receptors with [N‐11C‐methyl]‐benztropine and application to studies of propofol‐induced unconsciousness in healthy human volunteers , 2004, Synapse.

[36]  C. Kilts,et al.  Synthesis, radiosynthesis, and biological evaluation of carbon-11 and fluorine-18 labeled reboxetine analogues: potential positron emission tomography radioligands for in vivo imaging of the norepinephrine transporter. , 2009, Journal of medicinal chemistry.

[37]  Fang Sun,et al.  Willful modulation of brain activity in disorders of consciousness. , 2010, The New England journal of medicine.

[38]  Walter G Sannita,et al.  Unresponsive wakefulness syndrome: a new name for the vegetative state or apallic syndrome , 2010, BMC medicine.

[39]  J. Votaw,et al.  Synthesis, radiosynthesis, and biological evaluation of fluorine-18-labeled 2beta-carbo(fluoroalkoxy)-3beta-(3'-((Z)-2-haloethenyl)phenyl)nortropanes: candidate radioligands for in vivo imaging of the serotonin transporter with positron emission tomography. , 2008, Journal of medicinal chemistry.

[40]  N. Avril,et al.  The role of FDG-PET/CT in gynaecological cancers , 2012, Cancer imaging : the official publication of the International Cancer Imaging Society.

[41]  Steven Laureys,et al.  The Effect of Clonidine Infusion on Distribution of Regional Cerebral Blood Flow in Volunteers , 2008, Anesthesia and Analgesia.

[42]  Steven Laureys,et al.  Diagnostic precision of PET imaging and functional MRI in disorders of consciousness: a clinical validation study , 2014, The Lancet.

[43]  Athena Demertzi,et al.  Metabolic activity in external and internal awareness networks in severely brain-damaged patients. , 2012, Journal of rehabilitation medicine.

[44]  R. Haier,et al.  Functional brain imaging during anesthesia in humans: effects of halothane on global and regional cerebral glucose metabolism. , 1999, Anesthesiology.

[45]  David A Mankoff,et al.  Current and future uses of positron emission tomography in breast cancer imaging. , 2004, Seminars in nuclear medicine.

[46]  J. Y. Kao,et al.  Cerebral Metabolism during Propofol Anesthesia in Humans Studied with Positron Emission Tomography , 1995, Anesthesiology.

[47]  Steve Majerus,et al.  Functional neuroanatomy underlying the clinical subcategorization of minimally conscious state patients , 2012, Journal of Neurology.

[48]  E. Hoffman,et al.  Application of annihilation coincidence detection to transaxial reconstruction tomography. , 1975, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[49]  N. Nakayama,et al.  Relationship between regional cerebral metabolism and consciousness disturbance in traumatic diffuse brain injury without large focal lesions: an FDG-PET study with statistical parametric mapping analysis , 2006, Journal of Neurology, Neurosurgery & Psychiatry.

[50]  S. Aalto,et al.  Effects of Xenon Anesthesia on Cerebral Blood Flow in Humans: A Positron Emission Tomography Study , 2007, Anesthesiology.

[51]  Kjell Någren,et al.  Xenon Does Not Affect γ-Aminobutyric Acid Type A Receptor Binding in Humans , 2008, Anesthesia and analgesia.

[52]  Michael T. Alkire,et al.  Neuroimaging analysis of an anesthetic gas that blocks human emotional memory , 2008, Proceedings of the National Academy of Sciences.

[53]  R. Haier,et al.  Positron Emission Tomography Study of Regional Cerebral Metabolism in Humans during Isoflurane Anesthesia , 1997, Anesthesiology.

[54]  Jonathan A Javitch,et al.  Imaging the high-affinity state of the dopamine D2 receptor in vivo: fact or fiction? , 2012, Biochemical pharmacology.

[55]  Timo Kurki,et al.  Effects of Subanesthetic Doses of Ketamine on Regional Cerebral Blood Flow, Oxygen Consumption, and Blood Volume in Humans , 2003, Anesthesiology.

[56]  Athena Demertzi,et al.  Thalamus, Brainstem and Salience Network Connectivity Changes During Propofol-Induced Sedation and Unconsciousness , 2013, Brain Connect..

[57]  S. Aalto,et al.  Effects of Sevoflurane, Propofol, and Adjunct Nitrous Oxide on Regional Cerebral Blood Flow, Oxygen Consumption, and Blood Volume in Humans , 2003, Anesthesiology.

[58]  Z. Keidar,et al.  FDG-PET in prosthetic graft infections. , 2013, Seminars in nuclear medicine.

[59]  Alan C. Evans,et al.  Brain Mechanisms of Propofol-Induced Loss of Consciousness in Humans: a Positron Emission Tomographic Study , 1999, The Journal of Neuroscience.

[60]  Hiroki R. Hayama,et al.  Returning from Oblivion: Imaging the Neural Core of Consciousness , 2012, The Journal of Neuroscience.

[61]  Gustave Moonen,et al.  Cortical Processing of Noxious Somatosensory Stimuli in the Persistent Vegetative State , 2002, NeuroImage.

[62]  E. Rabiner,et al.  The Development, Past Achievements, and Future Directions of Brain PET , 2012, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[63]  N. Schwenzer,et al.  PET/CT, MR, and PET/MR in Lymphoma and Melanoma. , 2015, Seminars in nuclear medicine.

[64]  E. Hoffman,et al.  A positron-emission transaxial tomograph for nuclear imaging (PETT). , 1975, Radiology.

[65]  R. Rossaint,et al.  Positron emission tomography study of regional cerebral blood flow and flow-metabolism coupling during general anaesthesia with xenon in humans. , 2008, British journal of anaesthesia.

[66]  Alan C. Evans,et al.  Propofol anesthesia and cerebral blood flow changes elicited by vibrotactile stimulation: a positron emission tomography study. , 2001, Journal of neurophysiology.

[67]  Andreas Rimner,et al.  Role of FDG-PET scans in staging, response assessment, and follow-up care for non-small cell lung cancer , 2013, Front. Oncol..

[68]  Yen Kuang Yang,et al.  Serotonin and Mental Disorders: A Concise Review on Molecular Neuroimaging Evidence , 2014, Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology.

[69]  S. Aalto,et al.  Sevoflurane and Propofol Increase 11C-Flumazenil Binding to Gamma-Aminobutyric AcidA Receptors in Humans , 2004, Anesthesia and analgesia.

[70]  P. Herscovitch,et al.  Propofol Anesthesia Does Not Alter Regional Rates of Cerebral Protein Synthesis Measured with l-[1-11C]Leucine and PET in Healthy Male Subjects , 2009, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[71]  M. Schwaiger,et al.  Metabolic imaging predicts response, survival, and recurrence in adenocarcinomas of the esophagogastric junction. , 2006, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[72]  P. Piccini,et al.  Positron emission tomography imaging in multiple sclerosis–current status and future applications , 2011, European journal of neurology.

[73]  J. Votaw,et al.  Synthesis, radiosynthesis, and biological evaluation of carbon-11 labeled 2beta-carbomethoxy-3beta-(3'-((Z)-2-haloethenyl)phenyl)nortropanes: candidate radioligands for in vivo imaging of the serotonin transporter with positron emission tomography. , 2006, Journal of medicinal chemistry.

[74]  Brian A. Taylor,et al.  Advanced neuroimaging applied to veterans and service personnel with traumatic brain injury: state of the art and potential benefits , 2015, Brain Imaging and Behavior.

[75]  C. Boy,et al.  Positron Emission Tomography Study of Regional Cerebral Metabolism during General Anesthesia with Xenon in Humans , 2006, Anesthesiology.

[76]  Abraham Z. Snyder,et al.  Resting-state Functional Magnetic Resonance Imaging Correlates of Sevoflurane-induced Unconsciousness , 2015, Anesthesiology.

[77]  Ciprian Catana,et al.  Disruption of thalamic functional connectivity is a neural correlate of dexmedetomidine-induced unconsciousness , 2014, eLife.

[78]  A. Simmons,et al.  Neural correlates of malingering in mild traumatic brain injury: A positron emission tomography study , 2015, Psychiatry Research: Neuroimaging.

[79]  Steven Laureys,et al.  Brain function in coma, vegetative state, and related disorders , 2004, The Lancet Neurology.

[80]  Ryo Nakazato,et al.  Noninvasive imaging in coronary artery disease. , 2014, Seminars in nuclear medicine.

[81]  R. Haier,et al.  Correlating in vivo anaesthetic effects with ex vivo receptor density data supports a GABAergic mechanism of action for propofol, but not for isoflurane. , 2001, British journal of anaesthesia.

[82]  S. Aalto,et al.  The Effects of Xenon Anesthesia on the Relationship Between Cerebral Glucose Metabolism and Blood Flow in Healthy Subjects: A Positron Emission Tomography Study , 2009, Anesthesia and analgesia.

[83]  G. Manley,et al.  Imaging Concussion: A Review. , 2014, Neurosurgery.

[84]  J Schwinger.  Source theory analysis of electron-positron annihilation experiments. , 1975, Proceedings of the National Academy of Sciences of the United States of America.

[85]  M. Alkire,et al.  Quantitative EEG Correlations with Brain Glucose Metabolic Rate during Anesthesia in Volunteers , 1998, Anesthesiology.

[86]  UnCheol Lee,et al.  The directionality and functional organization of frontoparietal connectivity during consciousness and anesthesia in humans , 2009, Consciousness and Cognition.

[87]  M. Boly,et al.  Linking sleep and general anesthesia mechanisms: this is no walkover. , 2011, Acta anaesthesiologica Belgica.

[88]  C. Degueldre,et al.  Auditory processing in the vegetative state. , 2000, Brain : a journal of neurology.

[89]  Yiyun Huang,et al.  Awake Nonhuman Primate Brain PET Imaging with Minimal Head Restraint: Evaluation of GABAA-Benzodiazepine Binding with 11C-Flumazenil in Awake and Anesthetized Animals , 2013, The Journal of Nuclear Medicine.

[90]  David A Wolk,et al.  Multimodality Imaging of Alzheimer Disease and Other Neurodegenerative Dementias , 2014, The Journal of Nuclear Medicine.

[91]  Steven Laureys,et al.  Disorders of consciousness after acquired brain injury: the state of the science , 2014, Nature Reviews Neurology.

[92]  Steven Laureys,et al.  From armchair to wheelchair: How patients with a locked-in syndrome integrate bodily changes in experienced identity , 2012, Consciousness and Cognition.