Approaches to improving breast cancer diagnosis using a high resolution,breast specific gamma camera

Mammography remains the gold standard in breast cancer detection, although there remains a challenge for improvement in sensitivity of breast cancer detection and diagnosis. Although mammography is the most frequently utilized examination to screen for breast cancer, which has resulted in a reduction of breast cancer mortality, still some cancers are unable to be visualized on mammographic images. Mammography films are interpreted using an anatomic approach. A new approach to breast cancer diagnosis utilizes a breast specific gamma camera to measure radiotracer uptake of abnormal tissue in the breast in patients with an abnormal mammogram or palpble mass using technetium sestamibi. Images are taken using the same positioning techniques as mammography for comparison of both types of images. Multi-Institutional trials using a traditional gamma camera demonstrated potential for this approach. However, the inability of traditional gamma camera intrinsic resolution and non-optinuized breast imaging limited scintimammography. Therefore, a breast specific, high resolution gamma camera was developed to overcome these limitations.Results of clinical studies evaluating BSGI are promising and are increasingly being used. Additionally, means for minimally invasive imaging-guided acquisition of tissue are being developed so that biopsies will be avaibles for areas of interest based on radiotracer uptake.Breast specific gamma camera nuclear imaging of the breast is a developing and increasingly utilized approach to improving breast cancer detection and diagnosis.     

Technetium-99m monoclonal antibody fragment (FAb) scintigraphy in the evaluation of small cell lung cancer: a preliminary report

Small cell lung cancer (SCC) has the most rapid growth rate of the four cell types and metastasizes early. Present imaging modalities for staging include chest x-ray, CT, MRI and bone scans. In this preliminary study, we assessed the clinical role of ^99mTc-monoclonal antibody (MOAB) scintigraphy in five patients with histologically proven SCC. Each patient was infused with 20–30 mCi of ^99mTc labeled Fab fragment of MOAB (NR-LU-10, NeoRx, Seattle, Wash.). Total body simultaneous anterior and posterior images were obtained 14–16 h post injection. SPECT images of the chest were obtained through a 360 ° rotation of the gamma camera and recorded on a 62 × 64 × 16 matrix. Images (1.2cm thick) were generated in transaxial, sagittal and coronal views.Fourteen of fifteen chest lesions detected by CT were confirmed by ^99mTc MOAB scintigraphy. Scintigraphy detected one additional chest lesion not seen by CT. Scintigraphy failed to detect a brain lesion (2 cm), a chest lesion, and two adrenal lesions, all of which were seen by CT. In one patient with multiple (more than 10) lesions in the liver, both scintigraphy and CT detected all lesions. Three spine lesions seen on ^99mTc MDP scan and positive for metastasis on MRI concentrated ^99mTc MOAB, but two rib lesions seen on ^99mTc MDP bone scan did not concentrate ^99mTc MOAB. It is concluded from these preliminary results that the potential usefulness of ^99mTc MOAB scintigraphy as a complementary imaging modality in the staging of small cell lung cancer should be investigated further.     

Light sharing in multi-flat-panel-PMT PEM detectors

Large are a detectors, such as those used in positron emission mammography (PEM) and scintimammography, utilize arrays of discrete semtillator elements mounted on arrays of position sensitive photomultiplier tubes (PSPMT). Scintillator elements can be packed very densely (minimizing area between elements), allowing good detection sensitivity and spatial resolution. And, while new flat panel PSPMTS have minimal inactive edges, when they are placed in arrays significant dead spaces where scintillation light is undetectable are created. To address this problem, a light guide is often placed between the detector and PSPMT array to spread scintillation light so that these gaps can be bridged. In this investigation we studied the effect of light guides of various thickness on system performance. A 10×10 element array of LYSO detector elements was coupled to the center of a 2×2 array of PSPMTs through varying thicknesses (1 to 4 mm) of UV glass. The spot size of the imaged elements and distortions in the regular square pattern of the imaged scintillator arrays were evaluated. Energy resolution was measured by placing single elements of LYSO at several locations of the PSPMT array. Spatial distortions in the images of the array were reduced by using thicker light guides (3–4 mm). Use of thicker light guides, however, resulted in reduced pixel resolution and slight degradation of energy resolution. Therefore, some loss of pixel and energy resolution will accompany the use of thick light guides (minimum of 3 mm) required for optimum identification of detector elements.     

99mTc thyroid imaging system using multiple imaging plates

A system for taking static thyroid ^99mTc images was devised by using multiple imaging plates (IPs) and a low-energy high resolution collimator. System spatial resolution of the IP systems and the gamma camera was determined by referring to standards set by the National Electrical Manufacturers Association. Sensitivity was represented by using lower detection limits (LDLs). The sensitivity and resolution of IP systems using 16 IP probes connecting two collimators and 9 IPs were determined by using a 20 ml thyroid phantom, and compared with the sensitivity of gamma cameras. The sensitivity of the IP systems increased in proportion to the number of IPs. The sensitivity and resolution of a probe using 6 IPs and a high resolution collimator were equivalent to or superior to the gamma camera for taking static thyroid ^99mTc images. IP systems can be applied clinically as mobile static nuclear imaging devices. The performance of IP systems should be thoroughly investigated for combinations of various collimators and the number of IPs in order to verify their efficacy for imaging all organs.     

Lesion radioactivity concentration estimation using dual modality gamma ray/X-ray imaging

Although the use of dedicated gamma cameras in scintimammography permits closer access to the breast and improved spatial resolution relative to conventional gamma cameras, the task of quantifying the radiotracer concentration in the lesion relative to that in the surrounding breast tissue remains challenging because of the lesion-depth-dependent effects of attenuation and collimator blur. We are developing a dual modality scanner that combines digital x-ray mammography and a dedicated gamma camera on a common upright gantry. Here we present the results of a phantom study evaluating the use of the dual modality system for quantifying radioactivity in breast lesions. In addition to assessment of lesion activity, lesion volume estimates are necessary to quantify lesion radioactivity concentration. We have used multiple view x-ray imaging as a means of estimating lesion volume. Using phantom experiments, we have empirically derived a formula for correction of the measured z dimension of the lesion. The error obtained in quantification of lesion activity is approximately 10%. Lesion volume can be assessed with an accuracy comparable to that of lesion activity assessment using five x-ray views. These results suggest that the error in lesion concentration assessment is approximately 14%.     

Design and development of a dedicated portable gamma camera system for intra-operative imaging

PurposeWe developed a high performance portable gamma camera platform dedicated to identification of sentinel lymph nodes (SLNs) and radio-guided surgery for cancer patients. In this work, we present the performance characteristics of SURGEOSIGHT-I, the first version of this platform that can intra-operatively provide high-resolution images of the surveyed areas.MethodsAt the heart of this camera, there is a 43 × 43 array of pixelated sodium-activated cesium iodide (CsI(Na)) scintillation crystal with 1 × 1 mm² pixel size and 5 mm thickness coupled to a Hamamatsu H8500 flat-panel multi-anode (64 channels) photomultiplier tube. The probe is equipped with a hexagonal parallel-hole lead collimator with 1.2 mm holes. The detector, collimator, and the associated front-end electronics are encapsulated in a common housing referred to as head.ResultsOur results show a count rate of ∼41 kcps for 20% count loss. The extrinsic energy resolution was measured as 20.6% at 140 keV. The spatial resolution and the sensitivity of the system on the collimator surface was measured as 2.2 mm and 142 cps/MBq, respectively. In addition, the integral and differential uniformity, after uniformity correction, in useful field-of-view (UFOV) were measured 4.5% and 4.6%, respectively.ConclusionsThis system can be used for a number of clinical applications including SLN biopsy and radiopharmaceutical-guided surgery.     

CZT gamma camera for scintimammography

A high performance prototype gamma camera based on the semiconductor radiation detector Cd(Zn)Te is described. The camera features high spatial resolution, high-energy resolution, a reduced dead space on the edge of the field of view, and a compact format. The camera performance was first examined by comparison of small field of view examinations with those from an Elscint SP6HR standard clinical gamma camera. The new camera was found to give equal or improved image quality. The camera was then used for a systematic phantom study of small lesions in a background as would be found in breast cancer imaging. In this study the camera was able to systematically detect smaller, deeper, and fainter lesions. The camera is presently being used in a clinical trial aimed to assess its value in scintimammography where previous limitations of image quality and detector size have restricted the use of the functional imaging techniques. Preliminary results from 40 patients show high sensitivity and specificity with respect to X-ray mammography and surgery.     

Image processing algorithms to facilitate and enhance sentinel node detection using a hand-held gamma ray camera in surgical breast cancer staging

We have developed a miniature scintillation camera to be used in surgical cancer staging. The availability of such a compact hand-held gamma camera may in certain cases improve localization of the sentinel lymph node and reduce the duration of a surgical breast cancer staging procedure. We have investigated image processing algorithms applied to planar images that may improve node detection capabilities for breast cancer staging. We have also studied contrast enhancement methods that may be able to identify nodes that would otherwise be missed. Exposure duration for a given camera position can be adaptively shortened or increased by using an optical flow algorithm to estimate camera motion with respect to the current frame. By determining if the camera is in motion or not, the exposure time may be increased to allow more image counts to accumulate at a given camera position. Adaptive exposure time may improve the ease of use of the hand-held camera, and allow regions of interest to be imaged more effectively. We feel that these image processing techniques can improve the utility of a hand-held gamma ray imager for sentinel lymph node detection during breast cancer staging.     

Principal component analysis of scintimammographic images

The recent development of new gamma imagers based on scintillation array with high spatial resolution, has strongly improved the possibility of detecting sub-centimeter cancer in Scintimammography. However, Compton scattering contamination remains the main drawback since it limits the sensitivity of tumor detection. Principal component image analysis (PCA), recently introduced in scintimam nographic imaging, is a data reduction technique able to represent the radiation emitted from chest, breast healthy and damaged tissues as separated images. From these images a Scintimammography can be obtained where the Compton contamination is “removed”. In the present paper we compared the PCA reconstructed images with the conventional scintimammographic images resulting from the photopeak (Ph) energy window. Data coming from a clinical trial were used. For both kinds of images the tumor presence was quantified by evaluating the t-student statistics for independent sample as a measure of the signal-to-noise ratio (SNR). Since the absence of Compton scattering, the PCA reconstructed images shows a better noise suppression and allows a more reliable diagnostics in comparison with the images obtained by the photopeak energy window, reducing the trend in producing false positive.     

Evaluation of a dual-panel PET camera design to breast cancer imaging

We are developing a novel, portable dual-panel positron emission tomography (PET) camera dedicated to breast cancer imaging. With a sensitive area of ∼ 150 cm², this camera is based on arrays of lutetium oxyorthosilicate (LSO) crystals (1×1×3 mm³) coupled to 11×11-mm² position-sensitive avalanche photodiodes (PSAPD). GATE open source software was used to perform Monte Carlo simulations to optimize the parameters for the camera design. The noise equivalent counting (NEC) rate, together with the true, scatter, and random counting rates were simulated at different time and energy windows. Focal plane tomography (FPT) was used for visualizing the tumors at different depths between the two detector panels. Attenuation and uniformity corrections were applied to images.     

Evaluation of a SiPM array coupled to a Gd3Al2Ga3O12:Ce (GAGG:Ce) discrete scintillator

PurposeIn this study, we present the results of the evaluation of the SensL ArraySL-4 photo-detector, coupled to a 6 × 6 GAGG:Ce scintillator array, with 2 × 2 × 5 mm³ crystal size elements for possible applications in medical imaging detectors with focus in PET applications. Experimental evaluation was carried out with ²²Na and ¹³⁷Cs radioactive sources and the parameters studied were energy resolution and peak to valley ratio.MethodsArraySL-4 is a commercially available, 4 × 4 array detector covering an active area of 13.4 mm². The GAGG:Ce scintillator array used in this study has 0.1 mm thickness BaSO₄ reflector material between the crystal elements. A symmetric resistive voltage division matrix was applied, which reduces the 16 outputs of the array to 4 position signals. A Field Programmable Gate Array was used for triggering and digital processing of the signal pulses acquired using free running Analog to Digital Converters.ResultsRaw images and horizontal profiles of the 6 × 6 GAGG:Ce scintillator array produced under 511 keV and 662 keV excitation are illustrated. Moreover, the energy spectra obtained with ²²Na and ¹³⁷Cs radioactive sources from a single 2 × 2 × 5 mm³ GAGG:Ce scintillator are shown. The peak to valley ratio and the mean energy resolution values are reported.ConclusionsThe acquired raw image of the GAGG:Ce crystal array under 511 keV excitation shows a clear visualization of all discrete scintillator elements with a mean peak to valley ratio equal to 40. The mean energy resolution was measured equal to 10.5% and 9% respectively under 511 keV and 662 keV irradiation.     

A compact high‐speed full‐field optical coherence microscope for high‐resolution in vivo skin imaging

A compact high‐speed full‐field optical coherence microscope has been developed for high‐resolution in vivo imaging of biological tissues. The interferometer, in the Linnik configuration, has a size of 11 × 11 × 5 cm³ and a weight of 210 g. Full‐field illumination with low‐coherence light is achieved with a high‐brightness broadband light‐emitting diode. High‐speed full‐field detection is achieved by using part of the image sensor of a high‐dynamic range CMOS camera. En face tomographic images are acquired at a rate of 50 Hz, with an integration time of 0.9 ms. The image spatial resolution is 0.9 μm × 1.2 μm (axial × transverse), over a field of view of 245 × 245 μm². Images of human skin, revealing in‐depth cellular‐level structures, were obtained in vivo and in real‐time without the need for stabilization of the subject. The system can image larger fields, up to 1 × 1 mm², but at a reduced depth.      

Phantom evaluations of a dedicated dual-head scintimammography system

Results of aboratory evaluations are presented of the dual-head scintimammography system using two opposed and co-registered compact gamma heads. The system is intended for clinical studies imaging suspicious lesions in a compressed breast. The studies were performed using 5 cm and 6 cm compressed breast phantoms with lesion sizes from 6 to 10 mm and lesion to breast tissue activity ratios from 6 to 10. Two imagers with a field-of-view (FOV) of 15 cm×20 cm were placed on the opposite sides of the breast phartoms. In some studies anthropomorphic torso phantom was used to simulate realistic scatter gamma radiation field. Two types of parallel-hole lead collimators were employed. Combining the co-registered images from both detector heads resulted in an over two-fold increase in lesioin contrast in the central plane of the phantom and substantially increased detection sensitivity over the whole breast volume, especially of asymmetrically placed small lesions. The results confirm the important advantage of a co-registoed two-head scintimammography system over a single head system in lesion detection and localization.     

Resolution-recovery-embedded image reconstruction for a high-resolution animal SPECT system

The small-animal High-Resolution SPECT (HiReSPECT) is a dedicated dual-head gamma camera recently designed and developed in our laboratory for imaging of murine models. Each detector is composed of an array of 1.2 × 1.2 mm² (pitch) pixelated CsI(Na) crystals. Two position-sensitive photomultiplier tubes (H8500) are coupled to each head's crystal. In this paper, we report on a resolution-recovery-embedded image reconstruction code applicable to the system and present the experimental results achieved using different phantoms and mouse scans. Collimator-detector response functions (CDRFs) were measured via a pixel-driven method using capillary sources at finite distances from the head within the field of view (FOV). CDRFs were then fitted by independent Gaussian functions. Thereafter, linear interpolations were applied to the standard deviation (σ) values of the fitted Gaussians, yielding a continuous map of CDRF at varying distances from the head. A rotation-based maximum-likelihood expectation maximization (MLEM) method was used for reconstruction. A fast rotation algorithm was developed to rotate the image matrix according to the desired angle by means of pre-generated rotation maps. The experiments demonstrated improved resolution utilizing our resolution-recovery-embedded image reconstruction. While the full-width at half-maximum (FWHM) radial and tangential resolution measurements of the system were over 2 mm in nearly all positions within the FOV without resolution recovery, reaching around 2.5 mm in some locations, they fell below 1.8 mm everywhere within the FOV using the resolution-recovery algorithm. The noise performance of the system was also acceptable; the standard deviation of the average counts per voxel in the reconstructed images was 6.6% and 8.3% without and with resolution recovery, respectively.     

Intraoperative gamma imaging of axillary sentinel lymph nodes in breast cancer patients

Sentinel lymph node (SLN) biopsy is now standard practice in the management of many breast cancer patients. Localization protocols vary in complexity and rates of success. The least complex involve only intraoperative gamma counting of radiotracer uptake or intraoperative visualization of blue-dye uptake; the most complex involve preoperative gamma imaging, intraoperative counting and intraoperative dye visualization. Intraoperative gamma imaging may improve some protocols. This study was conducted to obtain preliminary experience and information regarding intraoperative imaging. Sixteen patients were enrolled: 8 in a protocol that included intraoperative counting and dye visualization (probe/dye), 8 in a protocol that involved intraoperative imaging, counting and dye visualization (camera/probe/dye). Preoperative imaging of all 16 patients was performed using a GE 500 gamma camera with a LEAP collimator (300 cpm/μCi). The results of this imaging were not, however, given to the surgeon until the surgeon had completed the procedures required for the study. A Care Wise C-Trak probe was used for intraoperative counting. A Gamma Medica Inc. GammaCAM/OR (12.5 × 12.5 cm FOV) with a LEHR collimator (135 cpm/μCi) was used for intraoperative imaging. Times from start of surgery to external detection of a radioactive focus and to completion of excision of SLNs were recorded. Foci were detected preoperatively via imaging in 16/16 patients. Intraoperative external detection using the probe was accomplished in less than 4 min (mean = 1.5 min) in 15/16 patients, and via intraoperative imaging in 6/8 patients. The average time for completion of excision of nodes was 19 min for probe/dye and 28 min for camera/probe/dye. In one probe/dye case, review of the preoperative images prompted the surgeon to resume axillary dissection and remove one additional SLN.     

Exploring TOF capabilities of PET detector blocks based on large monolithic crystals and analog SiPMs

Monolithic scintillators are more frequently used in PET instrumentation due to their advantages in terms of accurate position estimation of the impinging gamma rays both planar and depth of interaction, their increased efficiency, and expected timing capabilities. Such timing performance has been studied when those blocks are coupled to digital photosensors showing an excellent timing resolution.In this work we study the timing behaviour of detectors composed by monolithic crystals and analog SiPMs read out by an ASIC. The scintillation light spreads across the crystal towards the photosensors, resulting in a high number of SiPMs and ASIC channels fired. This has been studied in relation with the Coincidence Timing Resolution (CTR). We have used LYSO monolithic blocks with dimensions of 50 × 50 × 15 mm³ coupled to SiPM arrays (8 × 8 elements with 6 × 6 mm² area) which compose detectors suitable for clinical applications.While a CTR as good as 186 ps FWHM was achieved for a pair of 3 × 3 × 5 mm³ LYSO crystals, when using the monolithic block and the SiPM arrays, a raw CTR over 1 ns was observed. An optimal timestamp assignment was studied as well as compensation methods for the time-skew and time-walk errors. This work describes all steps followed to improve the CTR. Eventually, an average detector time resolution of 497 ps FWHM was measured for the whole thick monolithic block. This improves to 380 ps FWHM for a central volume of interest near the photosensors. The timing dependency with the photon depth of interaction and planar position are also included.     

An Exploratory Study on 99mTc-RGD-BBN Peptide Scintimammography in the Assessment of Breast Malignant Lesions Compared to 99mTc-3P4-RGD2

Purpose

This study aimed to explore the diagnostic performance of single photon emission computed tomography / computerized tomography (SPECT/CT) using a new radiotracer ^99mTc-RGD-BBN for breast malignant tumor compared with ^99mTc-3P4-RGD₂.

Methods

6 female patients with breast malignant tumors diagnosed by fine needle aspiration cytology biopsy (FNAB) who were scheduled to undergo surgery were included in the study. ^99mTc-3P4-RGD₂ and ^99mTc-RGD-BBN were performed with single photon emission computed tomography (SPECT) at 1 hour after intravenous injection of 299 ± 30 MBq and 293 ± 32 MBq of radiotracers respectively at separate day. The results were evaluated by the Tumor to non-Tumor ratios (T/NT). ^99mTc-RGD-BBN and ^99mTc-3P4-RGD₂ SPECT/CT images were interpreted independently by 3 experienced nuclear medicine physicians using a 3-point scale system. All of the samples were analyzed immunohistochemically to evaluate the integrin αvβ3 and gastrin-releasing peptide receptor (GRPR) expression. The safety, biodistribution and radiation dosimetry of ^99mTc-RGD-BBN were also evaluated in the healthy volunteers.

Results

No serious adverse events were reported in any of the patients during the study. The effective radiation dose entirely conformed to the relevant standards. A total of 6 palpable malignant lesions were detected using ^99mTc-RGD-BBN SPECT/CT with clear uptake. All malignant lesions were also detected using ^99mTc-3P4-RGD₂ SPECT/CT. The results showed that five malignant lesions were with clear uptake and the other one with barely an uptake. 4 malignant cases were found with both αvβ3 and GRPR expression, 1 case with only GRPR positive expression (integrin αvβ3 negative) and 1 case with only integrin αvβ3 positive expression (GRPR negative).

Conclusion

^99mTc-RGD-BBN is a safe agent for detecting breast cancer. ^99mTc-RGD-BBN may have the potential to make up for the deficiency of ^99mTc-3P4-RGD₂ in the detection of breast cancer with only GRPR positive expression (integrin α_vβ₃ negative). The preliminary application of ^99mTc-RGD-BBN has demonstrated its powerful potential in breast cancer diagnosis and therapy.     

A task-based evaluation of PEM detector element size

Positron Emission Mammography (PEM) is a planar imaging method that utilizes arrays of discrete detector elements for the detection of radiotracer-avid breast cancer. In this investigation we have systematically studied, through computer simulations, the effect of detector element size (width and length) on breast lesion detection and localization tasks. The contrast-to-noise ratios of the spheres simulating breast lesions were calculated as a function of detector element dimension to gauge detectability. System resolution (fwhm) across the field-of-view was used as the metric for the localization task. For both tasks, individual detector elements of lyso with cross sectional dimensions of 2×2 mm (96×72 element arrays, step 2.1mm) and 3×3mm (65×49 element arrays, step 3.1 mm), and lengths of 10,15 and 20 mm were simulated. The results revealed that narrower pixel dimensions reduced the partial volume effect, while the thicker pixels increased pixel sensitivity, thus reducing noise per pixel and increasing the contrast-to-noise ratio.     

The Italian multicentre dosimetric study for lesion dosimetry in 223Ra therapy of bone metastases: Calibration protocol of gamma cameras and patient eligibility criteria

PurposeThe aims of this work were to explore patient eligibility criteria for dosimetric studies in ²²³Ra therapy and evaluate the effects of differences in gamma camera calibration procedures into activity quantification.MethodsCalibrations with ²²³Ra were performed with four gamma cameras (3/8-inch crystal) acquiring planar static images with double-peak (82 and 154 keV, 20% wide) and MEGP collimator. The sensitivity was measured in air by varying activity, source-detector distance, and source diameter. Transmission curves were measured for attenuation/scatter correction with the pseudo-extrapolation number method, varying the experimental setup. ²²³Ra images of twenty-five patients (69 lesions) were acquired to study the lesions visibility. Univariate ROC analysis was performed considering visible/non visible lesions on ²²³Ra images as true positive/true negative group, and using as score value the lesion/soft tissue contrast ratio (CR) derived from ^99mTc-MDP WB scan.ResultsSensitivity was nearly constant varying activity and distance (maximum s.d. = 2%). Partial volume effects were negligible for object area ⩾960 mm². Transmission curve measurements are affected by experimental setup and source size, leading to activity quantification errors up to 20%. The ROC analysis yielded an AUC of 0.972 and an optimal threshold of CR of 10, corresponding to an accuracy of 92%.ConclusionThe minimum calibration protocol requires sensitivity and transmission curve measurements varying the object size, performing a careful procedure standardisation. Lesions with ^99mTc-MDP CR higher than 10, not overlapping the GI tract, are generally visible on ²²³Ra images acquired at 24 h after the administration, and possibly eligible for dosimetric studies.     

Kinetic analysis of 3H-serotonin accumulation in four regions of rat brain after lesions in the medial forebrain bundle

Kinetic analysis of ³H-serotonin accumulation by crude synaptosomal suspensions of neocortex, hippocampus and caudate or by whole homogenates of cerebellum revealed the presence of a high affinity uptake component having an apparent K_m for serotonin which ranged from 2.8 to 6.0 × 10^?8 M. A second, low affinity, uptake component with an apparent K_m of 7 × 10^?6 M was present in caudate. A comparable low affinity uptake component for serotonin was not observed in neocortex, hippocampus or cerebellum. Lesions in the medial forebrain bundle produced significant decreases in serotonin comtent of neocortes, hippocampus and caudate (66 to 75%) and a significant increase in serotonin content of cerebellum (25%). The lesions did not affect the apparent K_m of the high affinity uptake system but did produce change in V_max which paralleled the changes in content of serotonin. The lesions also produced decreases in dopamine and norepinephrine content of caudate and a comparable decrease in the V_max of the low affinity uptake system with no change in the apparent K_m. There was a correlation of 0.97 between the endogenous content of serotonin and the V_max of the high affinity uptake system. These results support the view that the high and low affinity components of serotonin uptake represent accumulation into serotonergic and catecholaminergic neurons, respectively.