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Myocardial blood flow quantitation using Rb-82: Validation to O-15-water in healthy volunteers and CAD patients

¹ Nuclear Medicine, CHUV University Hospital, Lausanne, Switzerland; ² Nuclear Cardiology, University Hospital, Zurich, Switzerland; ³ University Institute of Radiation Physics, Lausanne, Switzerland

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Objectives: We aimed at validating myocardial blood flow (MBF) quantitation with Rb-82 against O-15-water.

Methods: Global MBF (rest/adenosine stress) was assessed with PET (Discovery LS/ST) using Rb-82 (1100MBq) and O-15 (700MBq) in 21 controls (28±11y) and 12 CAD patients with no previous infarcts (60±13y). Data analysis used a 1-compartment model with correction for Rb-82 flow-dependent extraction and right+left ventricle spillover (PMOD 2.85 software). Myocardial flow reserve (MFR) was defined as stress/rest MBF. Results were compared using Lin’s concordance correlation _c (measure of both precision+accuracy), Pearson’s correlation , and Bland-Altman (BA) limits of agreement.

Results: Hemodynamical conditions were similar for O-15 and Rb-82 (p>0.28). Over the entire MBF range (Rb-82=0.50–4.9ml/min/g, O-15=0.66–4.7ml/min/g), MBF quantitation was excellent (_c=0.871, =0.898, mean difference=0.30±0.54ml/min/g, BA 95% limits=–0.77 to 1.36ml/min/g), and MFR was good (_c=0.689, =0.711, mean difference=–0.24±0.71, BA 95% limits=–1.6 to 1.17). MBF was reduced in CAD patients vs. controls with O-15 (2.65±0.81 vs. 3.43±0.93ml/min/g, p=0.01) or Rb-82 (2.21±0.87 vs. 3.02±0.96ml/min/g, p=0.02), and MFR was lower (O-15: 3.48±0.93 vs. 2.79±0.73, p=0.03; Rb-82: 3.66±0.83 vs. 3.03±1.00, p=0.04).

Conclusions: MBF quantitation with Rb-82 was excellent compared to O-15 over the common rest/adenosine stress MBF range in healthy controls and CAD patients. We herein suggest that generator-produced Rb-82 MBF quantitation could be used for clinical research as an alternative to cyclotron-produced radioisotopes.

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 Prior, J. Articles by Kaufmann, P. PubMed Articles by Prior, J. Articles by Kaufmann, P.