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Cardiovascular: Clinical ScienceClinical Science Posters |
1 National Cardiac PET Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
829
Objectives: Myocardial flow reserve (MFR) may be a useful adjunct to standard ECG-gated myocardial perfusion imaging. Previously, separate scans were needed to measure flow and ejection fraction (EF) with Rb-82 PET. This study evaluated single-scan quantification of MFR and EF reserve (EFR) in patients with normal vs. abnormal perfusion scans on the new DRX-VCT (GEHC).
Methods: 2D listmode Rb-82 rest and dipyridamole stress PET scans were acquired in 15 sequential patients referred for myocardial perfusion imaging, to reconstruct STATIC, DYNAMIC and ECG-GATED images. Segmental stress perfusion defects (<85% max) were used to define patient STATIC images as abnormal (n=8 ABN) or normal (n=7 NORM). DYNAMIC rest and stress images were processed automatically using FlowQuant© to quantify regional flow reserve (stress/rest MFR) and difference (stress–rest MFD mL/min/g) using a 1-compartment model with tracer extraction correction. GATED rest and stress images were processed with 4DM-SPECT© to measure stress–rest EFR %.
Results: Stress flow, MFR, MFD and EF were reduced* in ABN scans, with no difference in rest flow or EFR. MFR<2.2 was 88% sensitive and 100% specific to identify ABN scans. MFD<1.1 mL/min/g was 100% accurate, whereas EFR<0 was relatively inaccurate (44%).
Conclusions: MFR with listmode Rb-82 PET adds a new dimension to gated perfusion imaging. High specificity and negative predictive value of MFD & MFR may be useful to confirm adequate stress response and rule out microvascular disease in patients without evidence of epicardial coronary disease by standard imaging.
Research Support: CFI, ORF, HSFO
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