<i>On the Theory of the Indicator-Dilution Method for Measurement of Blood Flow and Volume</i>

Meier, P.; Zierler, Kenneth L.

doi:10.1152/jappl.1954.6.12.731

Cited by 1,185 publications

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“…For this reason, we have introduced the thermodynamic-activity coefficients 'Y I and 'Yz. This point has important implications in connection with Zierler's theorem (1965) and the Central Volume Principle (Stephenson, 1948(Stephenson, , 1958Meier and Zierler, 1954;Zierler, 1963 ;Roberts et ai ., 1973 ;Tilton et ai ., 1983). In particular, through applying Zierler's theorem (1965) to the model res idue functions described in this article, we have ob tained the evaluations Ai = 'Yhi' i = 1,2, ... , n, for the partition coefficients Ai in terms of the ther modynamic-activity coefficients of the tracer or of the systemic traced substance (in this article, sys temic water) .…”

Section: One-barrier Distributed-parameter Modelmentioning

confidence: 84%

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Tracer-Kinetic Models for Measuring Cerebral Blood Flow Using Externally Detected Radiotracers

Larson

Markham

Raichle

1987

J Cereb Blood Flow Metab

100

127

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Summary: All tracer-kinetic models currently employed with positron-emission tomography (PET) are based on compartmental assumptions. Our first indication that a compartmental model might suffer from severe limita tions in certain circumstances when used with PET oc curred when we implemented the Kety tissue-autoradiog raphy technique for measuring CBF and observed that the resulting CBF estimates, rather than remaining con stant (to within predictable statistical uncertainty) as ex pected, fe ll with increasing scan duration T when T > 1 min . After ruling out other explanations, we concluded that a one-compartment model does not possess suffi cient realism for adequately describing the movement of labeled water in brain. This article recounts our search for more realistic substitute models. We give our deriva tions and results for the residue-detection impulse re sponses for unit capillary-tissue systems of our two can didate distributed-parameter models. In a sequence of trials beginning with the simplest, we tested fo ur progres-The measurement of CBF is important not only because of the information it provides about the normal and diseased brain, but also because it is essential to other important measurements (e.g. , rate of oxygen consumption). Tr acer-kinetic models are employed with external radiation-detection de vices to interpret dynamic imaging data in terms of the movements of radiolabeled water (H 2 1 50) or other diffusible tracer (e.g. , [ 1 8F] fluoromethane) for the purpose of inferring CBF. The tracer-kinetic model currently employed with positron-emission tomography (PET) for this purpose is based on 443sively more detailed candidate models against data fr om appropriate residue-detection experiments. In these, we generated high-temporal-resolution counting-rate data re flecting the history of radiolabeled-water uptake and washout in the brains of rhesus monkeys. We describe our treatment of the data to yield model-independent em pirical values of CBF and of other parameters. By substi tuting these into our trial-model fu nctions , we were able to make direct comparisons of the model predictions with the experimental dynamic counting-rate histories, con firming that our reservations concerning the one-com partment model were well founded and obliging us to re ject two others . We conclude that a two-barrier distrib uted-parameter model has the potential of serving as a substitute for the Kety model in PET measurements of CBF in patients, especially when scan durations for T> 1 min are desired. Key Words: Cerebral blood flow-Dis tributed-parameter models-Po sitron-emission tomog raphy-Tissue heterogeneity-Tr acer kinetics. compartmental assumptions; that is , tracer is as sumed to move between discrete subvolumes, or "compartments," within each of which tracer is assumed to distribute instantaneously upon arrival. Thus, in a compartmental model, gradients of con centration are assumed to be zero (i.e. , their spatial profiles flat) within each compartment at all times. The compartmental mode...

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Section: One-barrier Distributed-parameter Modelmentioning

confidence: 84%

“…The technique used to compute CBF is based upon the well-established Central Volume Principle of tracer ki netics (Stephenson, 1948(Stephenson, , 1958Meier and Zierler, 1954 ;Zierler, 1963) . The details of our CBF technique have been published (Ter-Pogossian et al, 1969;Eichling et a!…”

Section: Discussionmentioning

confidence: 99%

Tracer-Kinetic Models for Measuring Cerebral Blood Flow Using Externally Detected Radiotracers

Larson

Markham

Raichle

1987

J Cereb Blood Flow Metab

100

127

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“…The stochastic or height/area method of analysis makes relatively few assumptions concerning the washout of xenon-133 from the tissue (Meier and Zierler, 1954). There is a close correspondence be tween either global CBF measured using the Kety Schmidt method and CBF (stochastic analysis) (lngvar et al, 1965) or hemispheric blood flow measured with radiolabelled microspheres and CBF determined stochastically (Marcus et al, 1981).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Quantitative Autoradiographic and Xenon-133 Clearance Methods: Correlation of Gray and White Matter Cerebral Blood Flow with Compartmental Blood Flow Indices

Tuor

Fitch

Graham

et al. 1986

J Cereb Blood Flow Metab

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Summary:The relationships between CBF in gray and white matter to those of the fast and slow components of xenon-133 clearance curves remain uncertain, CBF was measured in 13 anaesthetized baboons under a variety of conditions, using both the xenon-133 clearance technique and [14Cliodoantipyrine quantitative autoradiography. There was a linear relationship between CBF, as deter mined by the stochastic (height/area) analysis of the clearance curve, and mean CBF determined from the au toradiograms (r = 0.94, p < 0.001, slope = 0.86 ± 0.09). There was also a linear correlation between the fast-flow component (measured with xenon-133) and blood flow inThe xenon-133 clearance technique is widely used in both humans and laboratory animals to pro vide a measure of CBF (Hoedt-Rassmussen et aI., 1966;Lassen and Ingvar, 1972; Obrist et aI., 1975; Wyper et aI., 1976; Fitch et aI., 1978; Hetz et aI., 1984; Leli et aI., 1985). A common model of anal ysis of the xenon-133 clearance curves considers the clearances to be the result of the washout of tracer from two parallel compartments. These com partments, which clear at a fast and a slow rate, have been proposed to represent flow in cerebral gray matter and white matter, respectively (Hoedt Rasmussen et aI., 1966; Obrist et aI., 1975). How ever, this interpretation of the clearance curves re mains controversial (Iliff et aI. , 1974; Marcus et aI., 1981). In the present study, the relationship be- tween regional blood flow and the compartmental flow indices was investigated in the baboon using the excellent spatial resolution of quantitative [14C]iodoantipyrine autoradiography. Such a sys tematic investigation of the correlation between CBF measured with autoradiography and that mea sured with xenon-133 clearance has not been re ported previously in the primate. METHODS Animal preparationThe experiments were performed using 13 young, healthy baboons (5-11 kg) prepared in a manner identical to that established in this laboratory (Fitch et a!., 1978).Briefly, the animals were sedated with phencyclidine (10 mg/kg i.m.), anaesthetized with sodium thiopental (7.5 mg/kg), intubated, and connected to a positive-pressure ventilator supplied with a mixture of 70% NP and 30% 02' The ventilation was adjusted such that the animal was normocapnic (Pac02 �40 mm Hg) and normoxic (Pao2 � 100 mm Hg). Phencyclidine (0.01-0.02 mg/kg/min) was infused continuously to maintain anaesthesia, arterial blood pressure was monitored, and a normal body tem-

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“…They hypothesized that the bimodal thermodilution waveform may be explained by resistance to antegrade flow within the culprit coronary artery due to microvascular destruction 14. IMR derived from a bimodal curve incorporates a mean transit time derived from disordered antegrade coronary flow, potentially even transient retrograde flow, secondary to microvascular dysfunction 33. This scenario calls into question the validity of transit time as a proxy for flow when the thermodilution curve is bimodal.…”

Section: Discussionmentioning

confidence: 99%

Coronary Thermodilution Waveforms After Acute Reperfused ST‐Segment–Elevation Myocardial Infarction: Relation to Microvascular Obstruction and Prognosis

Yew

Carrick

Corcoran

et al. 2018

JAHA

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BackgroundInvasive measures of microvascular resistance in the culprit coronary artery have potential for risk stratification in acute ST‐segment–elevation myocardial infarction. We aimed to investigate the pathological and prognostic significance of coronary thermodilution waveforms using a diagnostic guidewire.Methods and ResultsCoronary thermodilution was measured at the end of percutaneous coronary intervention, (PCI) and contrast‐enhanced cardiac magnetic resonance imaging (MRI) was intended on day 2 and 6 months later to assess left ventricular (LV) function and pathology. All‐cause death or first heart failure hospitalization was a pre‐specified outcome (median follow‐up duration 1469 days). Thermodilution recordings underwent core laboratory assessment. A total of 278 patients with acute ST‐segment elevation myocardial infarction EMI (72% male, 59±11 years) had coronary thermodilution measurements classified as narrow unimodal (n=143 [51%]), wide unimodal (n=100 [36%]), or bimodal (n=35 [13%]). Microvascular obstruction and myocardial hemorrhage were associated with the thermodilution waveform pattern (P=0.007 and 0.011, respectively), and both pathologies were more prevalent in patients with a bimodal morphology. On multivariate analysis with baseline characteristics, thermodilution waveform status was a multivariable associate of microvascular obstruction (odds ratio [95% confidence interval]=5.29 [1.73, 16.22];, P=0.004) and myocardial hemorrhage (3.45 [1.16, 10.26]; P=0.026), but the relationship was not significant when index of microvascular resistance (IMR) >40 or change in index of microvascular resistance (5 per unit) was included. However, a bimodal thermodilution waveform was independently associated with all‐cause death and hospitalization for heart failure (odds ratio [95% confidence interval]=2.70 [1.10, 6.63]; P=0.031), independent of index of microvascular resistance>40, ST‐segment resolution, and TIMI (Thrombolysis in Myocardial Infarction) Myocardial Perfusion Grade.ConclusionsThe thermodilution waveform in the culprit coronary artery is a biomarker of prognosis and may be useful for risk stratification immediately after reperfusion therapy.

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On the Theory of the Indicator-Dilution Method for Measurement of Blood Flow and Volume

Cited by 1,185 publications

References 0 publications

Tracer-Kinetic Models for Measuring Cerebral Blood Flow Using Externally Detected Radiotracers

Tracer-Kinetic Models for Measuring Cerebral Blood Flow Using Externally Detected Radiotracers

Comparison of Quantitative Autoradiographic and Xenon-133 Clearance Methods: Correlation of Gray and White Matter Cerebral Blood Flow with Compartmental Blood Flow Indices

Coronary Thermodilution Waveforms After Acute Reperfused ST‐Segment–Elevation Myocardial Infarction: Relation to Microvascular Obstruction and Prognosis

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