Correction method for end-tidal xenon concentration in CBF measurements with xenon-enhanced CT

PURPOSE: The goal of this work is to show how variations in respiratory rate and tidal volume affect calculated cerebral blood flow (CBF) values on xenon-enhanced CT. In xenon-enhanced CT examination, the patient often takes shallow and rapid breaths. Thus, it is less likely that end-tidal xenon concentration reflects arterial xenon concentration, and appropriate correction measures should be taken for the end-distal respiratory data to obtain reliable CBF values. METHOD: Preliminary breathing tests were performed using a lung phantom to determine the influence of respiratory volume and rate on end-tidal xenon concentration. Two xenon-enhanced CT studies were conducted of a healthy person with completely different respiratory manners between two studies. One was deep and slow respiration. The other was shallow and rapid respiration. RESULTS: The lung phantom results prove that deep and slow respiration is essential for the end-tidal method. The results of xenon-enhanced CT studies of the same person show that the direct use of end-tidal data for shallow and rapid respiration leads to CBF values much lower than the actual values. CONCLUSION: Differences in respiratory rate and tidal volume during xenon inhalation can significantly affect calculated CBF values on xenon-enhanced CT. With use of the correction methods described herein, these effects can be minimized. We have derived the end-tidal correction method on the assumption that a person's CBF values should be kept unchanged regardless of different respiratory manners.