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⁸²Rb PET-CT for quantitative assessment of myocardial blood flow–validation in a canine model of coronary artery stenosis

¹ Johns Hopkins U, Baltimore, Maryland

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Objectives: Quantification of myocardial blood flow(MBF)expands the diagnostic potential of PET for assessment of diffuse coronary artery disease,microvascular dysfunction,and therapeutic effects. Using ⁸²Rb, current clinical perfusion analysis is still mostly limited to qualitative approaches.We evaluated the feasibility of MBF quantification using state-of-the-art hybrid PET-CT methodology.

Methods: 9 dogs were prepared with experimental coronary artery stenosis, followed by hybrid PET-CT imaging. PET was performed for 8min after intravenous injection of ⁸²Rb, during adenosine-induced vasodilation. Microspheres were used simultaneously for reference MBF. CT angiography was performed and co-registered with perfusion data to assign the myocardial regions to the stenotic vessel territory. Two methods for MBF calculation were employed:2-compartment model(2C)including spillover term, and retention index(RET).

Results: Without correction, significant underestimation occurred at higher flow due to nonlinear ⁸²Rb extraction. When applying previously established correction algorithms, MBF-2C was in good agreement with microsphere flow (y=0.20+0.84x; r=0.92, P<0.0001), although there was variability in the physiologic flow range below 3ml/g/min (y=0.53+0.54x; r=0.53, P=0.042). MBF-RET also correlated well with microsphere flow (y=0.52+0.47x; r=0.75, P=0.0004). Error increased with higher flow, but correlation was good in the physiologic range (y=0.29+0.62x; r=0.84, P=0.0001).

Conclusions: Using state-of-the-art PET-CT systems, quantification of MBF is feasible with ⁸²Rb. Approach based on tracer retention is practicable in the physiologic flow range. These results encourage further testing of robustness and usefulness in the clinical context of cardiac hybrid imaging.

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Lautamäki, R. Articles by Bengel, F. PubMed Articles by Lautamäki, R. Articles by Bengel, F.