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A Simplified Method for Quantification of Myocardial Blood Flow Using Nitrogen-13-Ammonia and Dynamic PET

Division of Nuclear Medicine and Biophysics, Department of Radiological Sciences, Laboratory of Nuclear Medicine (DOE), Laboratory of Biomedical and Environmental Sciences and the The Crump Institute for Biological Imaging, UCLA School of Medicine, Los Angeles, California

Correspondence: For correspondence or reprints contact: Yong Choi, PhD, Division of Nuclear Medicine and Biophysics, Department of Radiological Sciences, UCLA School of Medicine, 10833 Le Conte Ave., Los Angeles, CA 90024-1721.

ABSTRACT

The utility of Patlak graphical analysis was investigated for quantification of regional myocardial blood flow (MBF) and for generating parametric images of MBF with ¹³N-ammonia and dynamic PET imaging in dogs and humans. MBF was estimated by a two-compartment model fit of the initial 2 min of the kinetic data and by Patlak graphical analysis of the initial 2, 3, or 4 mm of data. In 11 dog studies, MBF by compartmental model fitting linearly correlated with MBF by microspheres (correlation coefficient (r) = 0.99, slope = 0.92) and by Patlak graphical analysis (r = 0.99, slope = 0.90). In 10 normal human studies, MBF obtained by the Patlak graphical analysis agreed well with MBF obtained by the compartmental model fitting (r = 0.96, slope = 1.04). Good agreement of the MBF estimates was also observed in 10 coronary artery disease patient studies (r = 0.96). Patlak graphical analysis permitted generation of parametric images of MBF. The parametric images of MBF, in units of ml/min/g, are of good image quality and have relatively low noise levels. We conclude that regional MBF can be noninvasively and conveniently measured with dynamic ¹³N-ammonia PET using either a two-compartment model or Patlak graphical analysis. MBF parametric images generated with the Patlak graphical analysis both map the distribution and quantitate the magnitude of myocardial perfusion abnormalities.

FOOTNOTES

^* Operated for the U.S. Department of Energy by the University of California under contract #DE-FCO3-87ER60615.

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