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Measurement of Myocardial Blood Flow with PET Using 1-¹¹C-Acetate

Division of Cardiology, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York

¹¹C-acetate has been used extensively for the noninvasive assessment of myocardial oxygen consumption and viability with PET. The use of early uptake of acetate by the heart to measure myocardial perfusion has been proposed. This study evaluated the application of ¹¹C-acetate for absolute measurement of myocardial blood flow using a simple compartmental model that does not require blood sampling. Methods: Eight healthy volunteers and 13 subjects with concentric left ventricular hypertrophy were studied under resting conditions with both ¹¹C-acetate and ¹⁵O-water. Myocardial blood flow with ¹¹C-acetate was obtained by fitting the first 3 min of the blood and tissue tracer activity curves to a two-compartment model. Flows obtained were compared with a validated approach using ¹⁵O-water. Results: In healthy volunteers, regional myocardial perfusion at rest estimated with ¹¹C-acetate was comparable with values obtained with ¹⁵O-water (1.06 ± 0.25 and 0.96 ± 0.12 mL/g/min, respectively). Perfusion in subjects with left ventricular hypertrophy was also comparable if the recovery coefficient (F_MM) used was corrected for ventricular mass. If a fixed F_MM was used, flow was greatly overestimated. F_MM could be estimated from left ventricular mass (F_MM = 0.46 + 0.002 x mass, r = 0.86, P < 0.0001). Conclusion: The results of this study suggest that ¹¹C-acetate can be applied to quantitatively estimate myocardial perfusion under resting conditions using a two-compartment model without the need for blood sampling, provided that an appropriate F_MM is chosen. This approach should increase the usefulness of this tracer and obviate administration of a separate tracer to independently measure perfusion.

Key Words: PET • myocardial blood flow • 1-¹¹C-acetate

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