Quantitative Dynamic Cardiac 82Rb PET Using Generalized Factor and Compartment Analyses

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FIGURE 1.
Simulated RV and LV input functions and associated myocardial TACs corresponding to 3 different sets of values of k₁ (mL/min/g) and k₂ (min⁻¹) as well as corresponding factors estimated with GFADS (open symbols). MYO = myocardium.
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FIGURE 2.
Estimated factors with VOI TACs and GFADS and GFADS-derived factor images. The 3-factor images were well separated with GFADS, whereas the LV+RV input functions were underestimated and the myocardial (MYO) TAC was overestimated with VOI TACs, due to spillover in early time points.
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FIGURE 3.
Estimated factors and factor images (3 transverse slices) with GFADS for a typical dynamic ⁸²Rb PET study in 93-y-old female with known CAD but with normal myocardial perfusion (SSS = 0). Radioactive decay was not compensated. LV, RV, and myocardium (MYO) were well separated using our uniqueness constraint.
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FIGURE 4.
Parametric maps of myocardial tissue extraction (k₁) and egress (k₂) as well as RV and LV contributions (f_vⁱ, r_vⁱ) from the patient dynamic study shown in Figure 3. Note absence of aberrant points due to orthogonal grouping.

TABLE 1

Clinical Data and Calculated Rest/Stress Myocardial Blood Flows for 13 Patients Included in Study

Subject no.	Sex	Age (y)	Prior CAD	BP* (mm Hg)	HR^† (bpm)	SSS^‡	k₁^§ (mL/min/g)	CFR^¶	k₂^∥ (1/min)	Catheterization results
1	F	59	No	122/73 − 106/50	79 − 94	0	0.80 − 1.84	2.3	0.015 − 0.028	NP
2	F	83	No	99/61 − 107/54	88 − 87	0	0.69 − 1.48	2.14	0.013 − 0.024	NP
3	F	76	No	145/83 − 131/65	74 − 83	0	0.64 − 1.34	2.09	0.012 − 0.018	NP
4	F	93	No	197/50 − 166/65	71 − 75	0	0.78 (rest)	—	0.020 (rest)	NP
5	F	43	No	107/60 − 99/48	61 − 87	0	1.07 (rest)	—	0.013 (rest)	NP
6	M	38	No	141/71 − 119/51	69 − 83	0	1.82 (stress)	—	0.022	NP
7	M	65	No	—	—	0	1.03 (rest)	—	0.014	NP
8	M	56	Yes	—	—	—	0.61 (rest)	—	0.015	80% LAD, 80% LCX, 90% RCA
9	M	66	Yes	127/65 − 100/52	50 − 72	27	0.58 − 0.87	1.5	0.013 − 0.018	NP
10	M	81	Yes	138/68 − 100/56	71 − 91	26	0.52 − 0.74	1.43	0.011 − 0.014	100% LAD, 90% RCA
11	F	76	Yes	117/62 − 116/54	58 − 62	28	0.61 − 0.84	1.39	0.012 − 0.016	Grafts patent
12	M	60	No	203/98 − 127/58	77 − 97	4	0.60 − 0.94	1.58	0.013 − 0.019	NP
13	M	56	Yes	119/77 − 118/70	78 − 93	18	0.67 − 1.01	1.51	0.017 − 0.021	Grafts patent

↵* BP (mm Hg): rest systolic/diastolic blood pressure − peak hyperemia systolic/diastolic blood pressure.
↵^† HR (bpm): rest heart rate − peak heart rate (bpm).
↵^‡ SSS: summed stress score (<3, normal; 4–8, mildly abnormal; 9–13, moderately abnormal; 13, severely abnormal).
↵^§ k₁ (mL/min/g): rest k₁ − stress k₁.
↵^¶ CFR: coronary flow reserve (k₁ stress/k₁ rest).
↵^∥ k₂ (1/min): rest k₂ − stress k₂.
NP = not performed; LAD = left anterior descending; LCX = left circumflex artery; RCA = right coronary artery.