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<meta name="DC.Title" content="Xenon-Enhanced Cerebral Blood Flow at 28% Xenon Provides Uniquely Safe Access to Quantitative, Clinically Useful Cerebral Blood Flow Information: A Multicenter Study" />
<meta name="DC.Identifier" content="10.3174/ajnr.A2522" />
<meta name="DC.Date" content="2011-08-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Xe-CT measures CBF and can be used to make clinical treatment decisions. Availability has been limited, in part due to safety concerns. Due to improvements in CT technology, the concentration of inhaled xenon gas has been decreased from 32% to 28%. To our knowledge, no data exist regarding the safety profile of this concentration. We sought to better determine the safety profile of this lower concentration through a multicenter evaluation of adverse events reported by all centers currently performing xenon/CT studies in the US.

MATERIALS AND METHODS: Patients were prospectively recruited at 7 centers to obtain safety and efficacy information. All studies were performed to answer a clinical question. All centers used the same xenon delivery system. CT imaging was used during a 4.3-minute inhalation of 28% xenon gas. Vital signs were monitored on all patients throughout each procedure. Occurrence and severity of adverse events were recorded by the principal investigator at each site.

RESULTS: At 7 centers, 2003 studies were performed, 1486 (74.2%) in nonventilated patients. The most common indications were occlusive vascular disease and ischemic stroke; 93% of studies were considered clinically useful. Thirty-nine studies (1.9%) caused respiratory suppression of &gt;20 seconds, all of which resolved spontaneously. Shorter respiratory pauses occurred in 119 (5.9%), and hyperventilation, in 34 (1.7%). There were 53 additional adverse events (2.9%), 7 of which were classified as severe. No adverse event resulted in any persistent neurologic change or other sequelae.

CONCLUSIONS: Xe-CT CBF can be performed safely, with a very low risk of adverse events and, to date, no risk of permanent morbidity or sequelae. On the basis of the importance of the clinical information gained, Xe-CT should be made widely available.

CBF
:   cerebral blood flow
ED
:   emergency department
FDA
:   US Food and Drug Administration
ICP
:   intracranial pressure
IND
:   investigational new drug
pCO2
:   carbon dioxide partial pressure
PRS
:   prolonged respiratory suppression
TIA
:   transient ischemic attack
Xe-CT
:   xenon-enhanced CT" />
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<meta name="DC.Contributor" content="E. Zager" />
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<meta name="DC.Contributor" content="M.P. Marks" />
<meta name="DC.Contributor" content="C. Robertson" />
<meta name="DC.Contributor" content="G.P. Sinson" />
<meta name="DC.Contributor" content="A. Marmarou" />
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<meta name="article:published_time" content="2011-08-01" />
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<meta name="citation_title" content="Xenon-Enhanced Cerebral Blood Flow at 28% Xenon Provides Uniquely Safe Access to Quantitative, Clinically Useful Cerebral Blood Flow Information: A Multicenter Study" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Xe-CT measures CBF and can be used to make clinical treatment decisions. Availability has been limited, in part due to safety concerns. Due to improvements in CT technology, the concentration of inhaled xenon gas has been decreased from 32% to 28%. To our knowledge, no data exist regarding the safety profile of this concentration. We sought to better determine the safety profile of this lower concentration through a multicenter evaluation of adverse events reported by all centers currently performing xenon/CT studies in the US.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Patients were prospectively recruited at 7 centers to obtain safety and efficacy information. All studies were performed to answer a clinical question. All centers used the same xenon delivery system. CT imaging was used during a 4.3-minute inhalation of 28% xenon gas. Vital signs were monitored on all patients throughout each procedure. Occurrence and severity of adverse events were recorded by the principal investigator at each site.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;At 7 centers, 2003 studies were performed, 1486 (74.2%) in nonventilated patients. The most common indications were occlusive vascular disease and ischemic stroke; 93% of studies were considered clinically useful. Thirty-nine studies (1.9%) caused respiratory suppression of &amp;gt;20 seconds, all of which resolved spontaneously. Shorter respiratory pauses occurred in 119 (5.9%), and hyperventilation, in 34 (1.7%). There were 53 additional adverse events (2.9%), 7 of which were classified as severe. No adverse event resulted in any persistent neurologic change or other sequelae.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Xe-CT CBF can be performed safely, with a very low risk of adverse events and, to date, no risk of permanent morbidity or sequelae. On the basis of the importance of the clinical information gained, Xe-CT should be made widely available.&lt;/p&gt;" />
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<meta name="twitter:title" content="Xenon-Enhanced Cerebral Blood Flow at 28% Xenon Provides Uniquely Safe Access to Quantitative, Clinically Useful Cerebral Blood Flow Information: A Multicenter Study" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Xe-CT measures CBF and can be used to make clinical treatment decisions. Availability has been limited, in part due to safety concerns. Due to improvements in CT technology, the concentration of inhaled xenon gas has been decreased from 32% to 28%. To our knowledge, no data exist regarding the safety profile of this concentration. We sought to better determine the safety profile of this lower concentration through a multicenter evaluation of adverse events reported by all centers currently performing xenon/CT studies in the US.

MATERIALS AND METHODS: Patients were prospectively recruited at 7 centers to obtain safety and efficacy information. All studies were performed to answer a clinical question. All centers used the same xenon delivery system. CT imaging was used during a 4.3-minute inhalation of 28% xenon gas. Vital signs were monitored on all patients throughout each procedure. Occurrence and severity of adverse events were recorded by the principal investigator at each site.

RESULTS: At 7 centers, 2003 studies were performed, 1486 (74.2%) in nonventilated patients. The most common indications were occlusive vascular disease and ischemic stroke; 93% of studies were considered clinically useful. Thirty-nine studies (1.9%) caused respiratory suppression of &gt;20 seconds, all of which resolved spontaneously. Shorter respiratory pauses occurred in 119 (5.9%), and hyperventilation, in 34 (1.7%). There were 53 additional adverse events (2.9%), 7 of which were classified as severe. No adverse event resulted in any persistent neurologic change or other sequelae.

CONCLUSIONS: Xe-CT CBF can be performed safely, with a very low risk of adverse events and, to date, no risk of permanent morbidity or sequelae. On the basis of the importance of the clinical information gained, Xe-CT should be made widely available.

CBF
:   cerebral blood flow
ED
:   emergency department
FDA
:   US Food and Drug Administration
ICP
:   intracranial pressure
IND
:   investigational new drug
pCO2
:   carbon dioxide partial pressure
PRS
:   prolonged respiratory suppression
TIA
:   transient ischemic attack
Xe-CT
:   xenon-enhanced CT" />
<meta name="og-title" property="og:title" content="Xenon-Enhanced Cerebral Blood Flow at 28% Xenon Provides Uniquely Safe Access to Quantitative, Clinically Useful Cerebral Blood Flow Information: A Multicenter Study" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/32/7/1315" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Xe-CT measures CBF and can be used to make clinical treatment decisions. Availability has been limited, in part due to safety concerns. Due to improvements in CT technology, the concentration of inhaled xenon gas has been decreased from 32% to 28%. To our knowledge, no data exist regarding the safety profile of this concentration. We sought to better determine the safety profile of this lower concentration through a multicenter evaluation of adverse events reported by all centers currently performing xenon/CT studies in the US.

MATERIALS AND METHODS: Patients were prospectively recruited at 7 centers to obtain safety and efficacy information. All studies were performed to answer a clinical question. All centers used the same xenon delivery system. CT imaging was used during a 4.3-minute inhalation of 28% xenon gas. Vital signs were monitored on all patients throughout each procedure. Occurrence and severity of adverse events were recorded by the principal investigator at each site.

RESULTS: At 7 centers, 2003 studies were performed, 1486 (74.2%) in nonventilated patients. The most common indications were occlusive vascular disease and ischemic stroke; 93% of studies were considered clinically useful. Thirty-nine studies (1.9%) caused respiratory suppression of &gt;20 seconds, all of which resolved spontaneously. Shorter respiratory pauses occurred in 119 (5.9%), and hyperventilation, in 34 (1.7%). There were 53 additional adverse events (2.9%), 7 of which were classified as severe. No adverse event resulted in any persistent neurologic change or other sequelae.

CONCLUSIONS: Xe-CT CBF can be performed safely, with a very low risk of adverse events and, to date, no risk of permanent morbidity or sequelae. On the basis of the importance of the clinical information gained, Xe-CT should be made widely available.

CBF
:   cerebral blood flow
ED
:   emergency department
FDA
:   US Food and Drug Administration
ICP
:   intracranial pressure
IND
:   investigational new drug
pCO2
:   carbon dioxide partial pressure
PRS
:   prolonged respiratory suppression
TIA
:   transient ischemic attack
Xe-CT
:   xenon-enhanced CT" />
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    <title>Xenon-Enhanced Cerebral Blood Flow at 28% Xenon Provides Uniquely Safe Access to Quantitative, Clinically Useful Cerebral Blood Flow Information: A Multicenter Study | American Journal of Neuroradiology</title>  
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      <h1 class="highwire-cite-title" id="page-title">Xenon-Enhanced Cerebral Blood Flow at 28% Xenon Provides Uniquely Safe Access to Quantitative, Clinically Useful Cerebral Blood Flow Information: A Multicenter Study</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">A.P. Carlson</span>, <span class="highwire-citation-author" data-delta="1">A.M. Brown</span>, <span class="highwire-citation-author" data-delta="2">E. Zager</span>, <span class="highwire-citation-author" data-delta="3">K. Uchino</span>, <span class="highwire-citation-author" data-delta="4">M.P. Marks</span>, <span class="highwire-citation-author" data-delta="5">C. Robertson</span>, <span class="highwire-citation-author" data-delta="6">G.P. Sinson</span>, <span class="highwire-citation-author" data-delta="7">A. Marmarou</span> and <span class="highwire-citation-author" data-delta="8">H. Yonas</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">August 2011,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">32 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1315-1320; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A2522 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-11427--6528273357" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">A.P. Carlson </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.P.%2BCarlson%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Carlson%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.P.%2BCarlson%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">A.M. 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<p id="p-2"><strong>BACKGROUND AND PURPOSE:</strong> Xe-CT measures CBF and can be used to make clinical treatment decisions. Availability has been limited, in part due to safety concerns. Due to improvements in CT technology, the concentration of inhaled xenon gas has been decreased from 32% to 28%. To our knowledge, no data exist regarding the safety profile of this concentration. We sought to better determine the safety profile of this lower concentration through a multicenter evaluation of adverse events reported by all centers currently performing xenon/CT studies in the US.</p>
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<p id="p-3"><strong>MATERIALS AND METHODS:</strong> Patients were prospectively recruited at 7 centers to obtain safety and efficacy information. All studies were performed to answer a clinical question. All centers used the same xenon delivery system. CT imaging was used during a 4.3-minute inhalation of 28% xenon gas. Vital signs were monitored on all patients throughout each procedure. Occurrence and severity of adverse events were recorded by the principal investigator at each site.</p>
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<p id="p-4"><strong>RESULTS:</strong> At 7 centers, 2003 studies were performed, 1486 (74.2%) in nonventilated patients. The most common indications were occlusive vascular disease and ischemic stroke; 93% of studies were considered clinically useful. Thirty-nine studies (1.9%) caused respiratory suppression of &gt;20 seconds, all of which resolved spontaneously. Shorter respiratory pauses occurred in 119 (5.9%), and hyperventilation, in 34 (1.7%). There were 53 additional adverse events (2.9%), 7 of which were classified as severe. No adverse event resulted in any persistent neurologic change or other sequelae.</p>
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<p id="p-5"><strong>CONCLUSIONS:</strong> Xe-CT CBF can be performed safely, with a very low risk of adverse events and, to date, no risk of permanent morbidity or sequelae. On the basis of the importance of the clinical information gained, Xe-CT should be made widely available.</p>
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</div><div class="section glossary" id="glossary-1"><h2>Abbreviations</h2><dl id="def-list-1"><dt id="def-item-1">CBF<span class="def-item-dt-sep"></span></dt><dd>cerebral blood flow<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">ED<span class="def-item-dt-sep"></span></dt><dd>emergency department<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">FDA<span class="def-item-dt-sep"></span></dt><dd>US Food and Drug Administration<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">ICP<span class="def-item-dt-sep"></span></dt><dd>intracranial pressure<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">IND<span class="def-item-dt-sep"></span></dt><dd>investigational new drug<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">pCO<sub>2</sub><span class="def-item-dt-sep"></span></dt><dd>carbon dioxide partial pressure<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">PRS<span class="def-item-dt-sep"></span></dt><dd>prolonged respiratory suppression<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">TIA<span class="def-item-dt-sep"></span></dt><dd>transient ischemic attack<span class="def-item-dd-sep"></span></dd><dt id="def-item-9">Xe-CT<span class="def-item-dt-sep"></span></dt><dd>xenon-enhanced CT</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">Copyright © American Society of Neuroradiology</li></ul><div class="license" id="license-1"><p id="p-1">Indicates open access to non-subscribers at <a href="http://www.ajnr.org">www.ajnr.org</a></p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/32/7/1315.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 32</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 7 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Aug 2011 </div></div>
      
      
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      <div class="highwire-cite-title">Xenon-Enhanced Cerebral Blood Flow at 28% Xenon Provides Uniquely Safe Access to Quantitative, Clinically Useful Cerebral Blood Flow Information: A Multicenter Study</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">A.P.</span> <span class="nlm-surname">Carlson</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">A.M.</span> <span class="nlm-surname">Brown</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">E.</span> <span class="nlm-surname">Zager</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">K.</span> <span class="nlm-surname">Uchino</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">M.P.</span> <span class="nlm-surname">Marks</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Robertson</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">G.P.</span> <span class="nlm-surname">Sinson</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Marmarou</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">H.</span> <span class="nlm-surname">Yonas</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Aug 2011, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">32 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1315-1320; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2522 </span></div>
  
  
  
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      <div class="highwire-cite-title">Xenon-Enhanced Cerebral Blood Flow at 28% Xenon Provides Uniquely Safe Access to Quantitative, Clinically Useful Cerebral Blood Flow Information: A Multicenter Study</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">A.P.</span> <span class="nlm-surname">Carlson</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">A.M.</span> <span class="nlm-surname">Brown</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">E.</span> <span class="nlm-surname">Zager</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">K.</span> <span class="nlm-surname">Uchino</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">M.P.</span> <span class="nlm-surname">Marks</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Robertson</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">G.P.</span> <span class="nlm-surname">Sinson</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Marmarou</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">H.</span> <span class="nlm-surname">Yonas</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Aug 2011, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">32 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1315-1320; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2522 </span></div>
  
  
  
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