Stable Xenon CT/CBF Imaging: Laboratory and Clinical Experience

  • Howard Yonas
  • David Gur
  • Richard Latchaw
  • Sidney K. WolfsonJr.
Part of the Advances and Technical Standards in Neurosurgery book series (NEUROSURGERY, volume 15)


Since Winkler in 1977 determined that the radiodensity of xenon could be used for image enhancement during transmission computerized tomography44, a number of groups have explored the possibility of using stable xenon as a tracer of cerebral blood flow (CBF). In 1978, Kelcz and coworkers25 defined the CT enhancement characteristics of stable xenon at the same time that Drayer, et al.6 reported early experiments with the direct measurement of CBF. Since that time, work has continued in the search to determine the best route by which to characterize the time course of arterial and tisssue enhancement, as well as calculate CBF using this new technique.


Cerebral Blood Flow Brain Death Regional Cerebral Blood Flow Local Cerebral Blood Flow Xenon Concentration 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Clark F, Yonas H, Gur D: Alteration of respiration rate and end exhalation CO2 during inhalation of subanesthetic levels of xenon gas. J Comput Assist Tomogr (in press)Google Scholar
  2. 2.
    Darby JD, Yonas H, Brenner R: Brainstem death with persistent EEG activity: evaluation by xenon-enhanced computed tomography. Critical Care Medicine 15 (5): 519–521.Google Scholar
  3. 3.
    Darby JD, Yonas H, Gur D, Latchaw RE: Xenon-enhanced computed tomography in brain death. Archives of Neurology 44: 551–554.Google Scholar
  4. 4.
    Dhawan V, Goldiner P, Ray C, Conti J, Rottenberg DA (1982) Mass spectrometric measurements of end-tidal xenon concentration for clinical stable xenon/computerized tomography cerebral blood flow studies. Biomed Mass Spectrom 9 (6): 241–245PubMedCrossRefGoogle Scholar
  5. 5.
    Dhawan V, Haughton VM, Thaler HT, Lu HC, Rottenberg DA (1984) Accuracy of stable xenon/CT measurements of regional cerebral blood flow: effect of extrapolated estimates of brain-blood partition coefficients. J Comput Assist Tomogr 8 (2): 208–212PubMedGoogle Scholar
  6. 6.
    Drayer BP, Wolfson SK Jr, Reinmuth OM, etal (1978) Xenon enhanced computed tomography for the analysis of cerebral integrity, perfusion, and blood flow. Stroke 9: 123–130PubMedCrossRefGoogle Scholar
  7. 7.
    Drayer BP, Gur D, Yonas H, Wolfson SK Jr, Cook EE (1980) Abnormality of the xenon brain-blood partition coefficient and blood flow cerebral infarction: an in vivo assessment using transmission computed tomography. Radiology 135 (2): 349–354PubMedGoogle Scholar
  8. 8.
    Eidelman BH, Hospodar M, Ratcliff G, Gur D, Yonas H, Latchaw R, Deeb Z (1985) Dementia and stable xenon/CT cerebral blood flow in multiple sclerosis. J CBF and Metabol 5 (1): s45–46Google Scholar
  9. 9.
    Eidelman BH, Hospodar M, Gur D, Yonas H, Latchaw R, Deeb Z (1985) A comparison of cerebral blood flow and NMR imaging in chronic multiple sclerosis. J CBF and Metabol 5 (1): s47–48Google Scholar
  10. 10.
    Erba M, Yonas H, Latchaw RE: Balloon occlusion monitored by xe/CT CBF (in preparation)Google Scholar
  11. 11.
    Good WF, Gur D, Shabason L, Wolfson SK Jr, Yonas H, Latchaw RE, Herbert DL, Kennedy WH (1982) Errors associated with single-scan determinations of regional cerebral blood flow by xenon-enhanced CT. Physics in Medicine and Biology (London) 27 (4): 531–537PubMedCrossRefGoogle Scholar
  12. 12.
    Good WF, Gur D, Yonas H, Herron JM: Errors in CBF determinations by xenon-enhanced CT due to estimation of arterial xenon concentration (submitted)Google Scholar
  13. 13.
    Gur D, Yonas H, Wolfson SK Jr, Herbert D, Kennedy W, Drayer B, Shabason L (1981) Xenon and iodine enhanced cerebral CT: A closer look. Stroke 12 (5): 573–578PubMedCrossRefGoogle Scholar
  14. 14.
    Gur D, Yonas H, Herbert DL, Wolfson SK, Kennedy WH, Drayer BP, Gray J (1981) Xenon enhanced dynamic computed tomography: multilevel cerebral blood flow studies. J Comput Assist Tomogr 5 (3): 334–340PubMedCrossRefGoogle Scholar
  15. 15.
    Gur D, Wolfson SK, Yonas H, Good W, et al (1982) Progress in cerebrovascular disease: LCBF by xenon-enhanced CT. Stroke 13: 750–758PubMedCrossRefGoogle Scholar
  16. 16.
    Gur D, Good WF, Wolfson SK Jr, Yonas H, Shabason L (1982) In vivo mapping of local cerebral blood flow by xenon-enhanced computed tomography. Science 5: 1267–1268CrossRefGoogle Scholar
  17. 17.
    Gur D, Herron HM, Molter BS, Good BC, Albright RE, Miller JN, Drayer BP (1984) Simultaneous mass spectrometry and thermoconductivity measurements of end-tidal xenon concentrations: A comparison. Med Phys 11 (2): 208– 212CrossRefGoogle Scholar
  18. 18.
    Gur D, Good WF, Herbert DL, Yonas H, Wozney P, Thiel DH van, Wolfson SK Jr (1985) Mapping of human blood flow in the liver by the xenon/CT method. JCAT 9 (3): 447–450Google Scholar
  19. 19.
    Gur D, Yonas H, Jackson DL, Wolfson SK Jr, Rockette H, Good WF, Cook EE, Arena VC, Willy JA, Maitz GS (1985) Simultaneous measurements of cerebral blood flow by the xenon/CT method and the microsphere method: A comparison. Invest Radiol 20: 672–677PubMedCrossRefGoogle Scholar
  20. 20.
    Gur D, Yonas H, Jackson DL, Wolfson SK Jr, Rockette H, Good WF, Maitz GS, Cook EE, Arena VC (1985) Measurements of cerebral blood flow during xenon inhalation as measured by the microsphere method. Stroke 16: 871–874PubMedCrossRefGoogle Scholar
  21. 21.
    Haughton VM, Donesan JF, Walsh PR, Syvertsen A, Williams A (1980) A clinical evaluation of xenon enhancement for computed tomography. Invest Radiol 15 [6 Suppl]: sl60–163CrossRefGoogle Scholar
  22. 22.
    Harrington TR, Manwaring K, Hodak J (1986) Local basal ganglia and brain stem blood flow in the head injured patient using stable xenon-enhanced CT scanning. In: Miller JD, Teasdale GM, Rowan JV, Galbraith SL, Mendelow AD (eds) Intracranial pressure. Springer, Berlin Heidelberg New York TokyoGoogle Scholar
  23. 23.
    Hughes R, Yonas H, Gur D, et al: Stable xenon-enhanced CT in the first eight hours of cerebral infarction (in preparation)Google Scholar
  24. 24.
    Junck L, Dhawan V, Thaler HT, Rottenberg DA (1985) Effects of xenon and krypton on regional cerebral blood flow in the rat. J CBF and Metabol 5: 126–132Google Scholar
  25. 25.
    Kelcz F, Hilal SK, Hartwell P, Joseph PM (1978) Computed tomographic measurement of the xenon brain-blood partition coefficient and implication for regional cerebral blood flow: a preliminary report. Radiology 127: 385–392PubMedGoogle Scholar
  26. 26.
    Kishore PR, Rao Gu, Fernandez RE, Keenen RL, Arora GD, Gadisseux P, Steward LM, Wist AD, Fatouros PP, Dillard D, et al (1984) Regional cerebral blood flow measurements using stable xenon enhanced computed tomography: A theoretical and experimental evaluation. J Comput Assist Tomogr 8 (4): 619–630PubMedCrossRefGoogle Scholar
  27. 27.
    Koeze TH, Wylie IH (1980) Determination of cerebral blood flow with the EMI CT scanner. Br J Radiol 53 (629): 410–415PubMedCrossRefGoogle Scholar
  28. 28.
    Koeze TH, Wylie IH (1980) Determination of cerebral blood flow with the EMI CT scanner. Br J Radiol 53 (629): 410–415PubMedCrossRefGoogle Scholar
  29. 29.
    Meyer JS, Hayman LH, Yamamoto M, Sakal F, Nakajima S (1980) Local cerebral blood flow measured by CT after stable xenon inhalation. AJR 135 (2): 239–251PubMedGoogle Scholar
  30. 30.
    Meyer JS, Yamamoto M, Hayman LA, Sakai F, Nakajima S, Amstrong D (1980) Cerebral embolism: local CBF and edema measured by CT scanning and xenon inhalation. Neurol Res 2 (2): 101–126PubMedGoogle Scholar
  31. 31.
    Meyer JS, Nakajima S, Dkabe T, Amano T, Centeno R, Len YY, Levine J, Levinthal R, Rose J (1982) Redistribution of cerebral blood flow following STA/MCA bypass in patients with hemispheric ischemia. Stroke 13 (6): 774–784PubMedCrossRefGoogle Scholar
  32. 32.
    Meyer JS, Kitasawa Y, Tanahashi N, Iachibana H, Kanoula P, Cech DA, Rose JE, Grossman RG (1985) Pathogenesis of normal-pressure hydrocephalus-preliminary observations. Surg Neurol 23 (2): 121–133PubMedCrossRefGoogle Scholar
  33. 33.
    Nakamura D, Nomura K, Segawa H, Takakura K, Nakasome T, Yoshimasu N, Ueda Y, Kimura K, Nasai M (1985) Cerebral blood flow measured by xenon-enhanced CT in brain tumors. No Shinkei Geka 13 (1): 37–43PubMedGoogle Scholar
  34. 34.
    Obrist WD, Jaggi JL, Harel D, Smith DS (1985) Effect of stable xenon inhalation on human CBF. J CBF and Metabol 5 (1): s557–558Google Scholar
  35. 35.
    Panos PP, Fatouros R, Kishore PRS, Hall JA Jr, West AO, Dewitt DS, Marmarou A, Keenan R, Kantos H (1985) Comparison of improved stable xenon/CT method for cerebral blood flow measurements with radiolabeled microspheres technique. Radiology 158 (1): 334Google Scholar
  36. 36.
    Pittinger CB, Moyers J, Kuhlen SC (1953) Clinical pathologic studies associated with xenon anesthesia. Anesthesiology 14: 10PubMedCrossRefGoogle Scholar
  37. 37.
    Report of the National Institutes of Health Ad Hoc Working Group to Develop Radioepidemiological tables. Office of the Director of National Institutes of Health (Publ). No. 85–2748. January, 1985Google Scholar
  38. 38.
    Rottenberg DA, Lu HC, Kearfott KJ (1982) The in vivo autoradiographic measurement of regional cerebral blood flow using stable xenon and computerized tomography: The effect of tissue heterogeneity and computerized tomography noise. J CBF and Metabol 2 (2): 173–178Google Scholar
  39. 39.
    Segawa H (1985) Tomographic cerebral blood flow measurement using xenon inhalation and serial CT scanning: Normal values and its validity. Neurosurg Rev 8 (1): 27–33PubMedCrossRefGoogle Scholar
  40. 40.
    Sekhar LN, Schramm VL Jr, Jones NF, Yonas H, Horton J, Latchaw RE, Curtin H (1986) Operative exposure and management of the petrous and upper cervical internal carotid artery. Neurosurgery 19: 967–982PubMedCrossRefGoogle Scholar
  41. 41.
    Thaler HT, Baglivo JA, Lu HC, Rottenberg DA (1982): Repeated least squares analysis of simulated xenon computed tomographic measurements of regional cerebral blood flow. J CBF and Metab 2 (4): 408–414Google Scholar
  42. 42.
    Tachibana H, Meyer JS, Rose JE, Kandula P (1984) Local cerebral blood flow and partition coefficients measured in cerebral astrocytomas of different grades of malignancy. Surg Neurol 21 (2): 125–131PubMedCrossRefGoogle Scholar
  43. 43.
    Tachibana H, Meyer JS, Okayasu H, Shaw TG, Kandula P, Rogers RL (1984) Xenon contrast CT-CBF scanning of the brain differentiates normal age- related changes from multi-infarct dementia and senilé dementia of Alzheimer type. J Gerontol 39 (4): 415–423PubMedGoogle Scholar
  44. 44.
    Tachibana H, Meyer J, Kitagawa Y, Tanahashi N, Kandula P, Rogers RL (1985) Xenon contrast CT-CBF measurements in parkinsonism and normal aging. J Am Geriatr Soc 33 (6): 413–421PubMedGoogle Scholar
  45. 45.
    Vorstrup S, Engell HC, Lindewald H, Lassen NA (1984) Hemodynamically significant stenosis of the internal carotid artery treated with endarterectomy. J Neurosurg 60: 1070–1075PubMedCrossRefGoogle Scholar
  46. 46.
    Winkler S, Sackett J, Holden J, et al (1977) Xenon inhalation as an adjunct to computerized tomography of the brain. Preliminary study. Invest Radiol 12: 15PubMedCrossRefGoogle Scholar
  47. 47.
    Winkler S, Turski P (1985) Potential hazards of xenon inhalation. AJN 6: 974– 975Google Scholar
  48. 48.
    Wolfson SK Jr, Gur D, Yonas H: Autoregulation recorded by xenon/CT CBF measurements (in preparation)Google Scholar
  49. 49.
    Wozney P, Yonas H, Latchaw RE, Gur D, Good W (1985) Central herniation revealed by focal decrease in blood flow without elevation in ICP: A case report. Neurosurg 17 (4): 641–644CrossRefGoogle Scholar
  50. 50.
    Yonas H, Wolfson SK Jr, Dujovny M, Boehnke M, Cook E (1981) Selective lenticulostriate artery occlusion in the primate-A highly focal cerebral ischemic model. Stroke 12 (5): 567–572PubMedCrossRefGoogle Scholar
  51. 51.
    Yonas H, Grundy B, Gur D, Shabason L, Wolfson SK Jr, Cook E (1981) Side effects of xenon inhalation. J Comput Assist Tomogr 5: 591–592PubMedCrossRefGoogle Scholar
  52. 52.
    Yonas H, Wolfson SK Jr, Gur D, Latchaw RE, Good WF, Leanza R, Jackson DL, Jannetta PJ, Reinmuth OM (1984) Clinical experience with the use of xenon-enhanced CT blood flow mapping in cerebral vascular disease. Stroke 15 (3): 443–449PubMedCrossRefGoogle Scholar
  53. 53.
    Yonas H, Good WF, Gur D, Wolfson SK Jr, Latchaw RE, Good BC, Leanza R, Miller SL (1984) Mapping cerebral blood flow by xenon-enhanced computed tomography: Clinical experience. Radiology 152 (2): 425–442Google Scholar
  54. 54.
    Yonas H, Gur D, Good BC, Latchaw RE, Wolfson SK Jr, Good WF, Maitz GS (1985) Stable xenon/CT blood flow mapping in the evaluation of patients before and after extracranial/intracranial bypass surgery. J Neurosurg 62: 324– 333PubMedGoogle Scholar
  55. 55.
    Yonas H, Wolfson SK Jr, Cook EE, Gur D (1986) Selective lenticulostriate arterial occlusion: A reproducible model of primate focal cerebral ischemia. Surg Neurol 25: 545–552CrossRefGoogle Scholar
  56. 56.
    Yonas H, Wolfson SK Jr, Cook EE, Gur D (1986) Selective lenticulostriate arterial occlusion: A reproducible model of primate focal cerebral ischemia. Surg Neurol 25: 545–552CrossRefGoogle Scholar
  57. 57.
    Yonas H, Snyder JV, Gur D, Good WF, Latchaw RE, Wolfson SK Jr, Grenvik A, Good BC (1984) Local cerebral blood flow alterations (Xe-CT method) in an accident victim: A case report. J Comput Assist Tomogr 8 (5): 990–991PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag/Wien 1987

Authors and Affiliations

  • Howard Yonas
    • 1
  • David Gur
    • 2
  • Richard Latchaw
    • 3
  • Sidney K. WolfsonJr.
    • 4
  1. 1.Department of Neurological SurgeryUniversity of PittsburghUSA
  2. 2.Department of Radiological ImagingUniversity of PittsburghUSA
  3. 3.Department of RadiologyPresbyterian University HospitalPittsburghUSA
  4. 4.Department of Neurological SurgeryMontefiore HospitalPittsburghUSA

Personalised recommendations