Intrathecal 99mTc‐DTPA imaging of molecular passage from lumbar cerebrospinal fluid to brain and periphery in humans. Issue 1 (29th April 2020)

• Record Type: Journal Article
• Authors: Verma, Ajay; Hesterman, Jacob Y.; Chazen, J. Levi; Holt, Robert; Connolly, Patrick; Horky, Laura; Vallabhajosula, Shankar; Mozley, P. David
• Is Part Of: Alzheimer's & dementia. Volume 12:Issue 1(2020)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-04-29
• Subjects: brain clearance -- cerebrospinal fluid -- imaging -- biomarker -- intrathecal; Alzheimer's disease -- Periodicals; Alzheimer's disease -- Diagnosis -- Periodicals; Dementia -- Periodicals; Dementia -- Diagnosis -- Periodicals; 616.831
• DOI: 10.1002/dad2.12030
• Languages: English
• ISSNs: 2352-8729

Abstract

Abstract: Introduction: Cerebrospinal fluid (CSF) molecular exchange with brain interstitial fluid (ISF) and periphery is implicated in neurological disorders but needs better quantitative clinical assessment approaches. Methods: Following intrathecal (ITH) dosing via lumbar puncture, Technetium‐99 m ( 99m Tc‐) diethylenetriaminepentaacetic acid (DTPA) imaging was used to quantify neuraxial spread, CSF‐brain molecular exchange, and CSF‐peripheral clearance in 15 normal human volunteers. The effect of experimental convection manipulation on these processes was also assessed. Results: Rostral cranial 99m Tc‐DTPA exposures were influenced by the volume of artificial CSF in the formulation. Signal translocation to the cranial cisterns and the brain parenchyma was observable by 3 hours. 99m Tc‐DTPA penetrated cortical ISF but showed lower signal in deeper structures. Urinary 99m Tc‐DTPA signal elimination was accelerated by higher formulation volumes and mechanical convection. Discussion: Widely used for detecting CSF leaks, ITH 99m Tc‐DTPA imaging can also become a useful clinical biomarker for measuring molecular exchange physiology between the CSF, brain, and periphery.