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Kinetic Analysis of ¹⁸F-Fluorodihydrorotenone as a Deposited Myocardial Flow Tracer: Comparison to ²⁰¹Tl

Department of Nuclear Medicine and Functional Imaging, E.O. Lawrence Berkeley National Laboratory, University of California, Berkeley, California

The goals of this investigation were to assess the accuracy of ¹⁸F-fluorodihydrorotenone (¹⁸F-FDHR) as a new deposited myocardial flow tracer and to compare the results to those for ²⁰¹Tl. Methods: The kinetics of these flow tracers in 22 isolated, erythrocyte- and albumin-perfused rabbit hearts were evaluated over a flow range encountered in patients. The 2 flow tracers plus a vascular reference tracer (¹³¹I-albumin) were introduced as a bolus through a port just above the aortic cannula. Myocardial extraction, retention, washout, and uptake parameters were computed from the venous outflow curves with the multiple-indicator dilution technique and spectral analysis. Results: The mean ± SD initial extraction fractions for ¹⁸F-FDHR (0.85 ± 0.07) and ²⁰¹Tl (0.87 ± 0.05) were not significantly different, although the initial extraction fraction for ¹⁸F-FDHR declined with flow (P < 0.0001), whereas the initial extraction fraction for ²⁰¹Tl did not. The washout of ²⁰¹Tl was faster (P < 0.001) and more affected by flow (P < 0.05) than was the washout of ¹⁸F-FDHR. Except for the initial extraction fraction, ¹⁸F-FDHR retention was higher (P < 0.001) and less affected by flow (P < 0.05) than was ²⁰¹Tl retention. Reflecting its superior retention, the net uptake of ¹⁸F-FDHR was better correlated with flow than was that of ²⁰¹Tl at both 1 and 15 min after tracer introduction (P < 0.0001 for both comparisons). Conclusion: The superior correlation of ¹⁸F-FDHR uptake with flow indicates that it is a better flow tracer than ²⁰¹Tl in the isolated rabbit heart. Compared with the other currently available positron-emitting flow tracers (⁸²Rb, ¹³N-ammonia, and ¹⁵O-water), ¹⁸F-FDHR has the potential of providing excellent image resolution without the need for an on-site cyclotron.

Key Words: myocardial perfusion • ¹⁸F-fluorodihydrorotenone • PET

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