Cerebral arterial inflow assessment with 18F-FDG PET: Methodology and feasibility

•We proposed the measurement of cerebral arterial inflow using 3-s bolus 18F-FDG brain PET acquisition.•The arrival of the bolus in the field of view was calculated directly in list mode acquisition.•Tubular structure enhancement filter was used to enhance vessels and a clustering step eliminated noise outside them.

Positron emission tomography (PET) with 18fluorodeoxyglucose (18F-FDG) is increasingly used in neurology. The measurement of cerebral arterial inflow (QA) using 18F-FDG complements the information provided by standard brain PET imaging. Here, injections were performed after the beginning of dynamic acquisitions and the time to arrival (t0) of activity in the gantry's field of view was computed. We performed a phantom study using a branched tube (internal diameter: 4 mm) and a 18F-FDG solution injected at 240 mL/min. Data processing consisted of (i) reconstruction of the first 3 s after t0, (ii) vascular signal enhancement and (iii) clustering. This method was then applied in four subjects. We measured the volumes of the tubes or vascular trees and calculated the corresponding flows. In the phantom, the flow was calculated to be 244.2 mL/min. In each subject, our QA value was compared with that obtained by quantitative cine-phase contrast magnetic resonance imaging; the mean QA value of 581.4 ± 217.5 mL/min calculated with 18F-FDG PET was consistent with the mean value of 593.3 ± 205.8 mL/min calculated with quantitative cine-phase contrast magnetic resonance imaging. Our 18F-FDG PET method constitutes a novel, fully automatic means of measuring QA.