Article Figures & Data
Figures
- FIGURE 1.
Typical factors and corresponding factor images associated with 82Rb (A) and 13N-ammonia (B) dynamic studies in same subject. AU = arbitrary units; MYO = whole myocardium.
- FIGURE 2.
Transverse, coronal, and sagittal slices (left) as well as short-axis, long-vertical-axis, and horizontal-axis images (top right) of 82Rb (A) and 13N-ammonia (B) stress studies in same subject. Polar maps of relative perfusion (center) and absolute hyperemic MBF (right) are also shown (bottom right); white corresponds to highest values in color scale.
- FIGURE 3.
Intraobserver and GFADS variability of estimation of rest MBF and stress MBF with 82Rb. Mean values for flow from 4 repeated estimates are shown for one observer.
- FIGURE 4.
Interobserver variability of estimation of CFR with 82Rb.
- FIGURE 5.
Reproducibility of rest MBF and stress MBF estimated with 82Rb at 2 visits. (A) Correlation plot of 2 MBF measurements. (B) Bland–Altman plot of 2 MBF measurements.
- FIGURE 6.
Comparison of rest MBF and stress MBF estimated with 82Rb and 13N-ammonia. (A) Correlation plot of 82Rb and 13N-ammonia MBF measurements. (B) Bland–Altman plot of 82Rb and 13N-ammonia MBF measurements. Bland–Altman plot illustrates slight overestimation of MBF at rest and underestimation during peak stress with 82Rb compared with 13N-ammonia.
Tables
Characteristic Reproducibility (n = 22) Accuracy (n = 20) Age (y) 48.0 ± 12.3 34.3 ± 11.6 Female/male ratio 11/11 12/8 Hypertension 4 1 Diabetes 2 0 Smoking 1 3 Dyslipidemia 5 4 Prior CAD 1 0 Prior MI 1 0 Chest pain 1 0 Chronic obstructive pulmonary disease 0 0 Data are reported as number of subjects unless otherwise indicated.
Reproducibility (mean ± SD, n = 22) Accuracy (mean ± SD, n = 20) Parameter 82Rb study 1 82Rb study 2 82Rb 13N ammonia Systemic hemodynamics HR at rest 65 ± 8 65 ± 9 64 ± 11 60 ± 9 Systolic BP at rest 135 ± 17 134 ± 16 126 ± 21 108 ± 8 Mean arterial BP at rest 91 ± 11 92 ± 21 84 ± 14 80 ± 13 RPP at rest 8,682 ± 1,368 8,717 ± 1,575 8,100 ± 2,423 6,588 ± 1,056 Peak HR 80 ± 14 83 ± 11 82 ± 16 87 ± 24 Peak systolic BP 139 ± 23 127 ± 20 124 ± 19 110 ± 16 Peak mean arterial BP 93 ± 15 84 ± 16 81 ± 13 73 ± 31 Peak RPP 11,053 ± 2,657 10,414 ± 2,137 10,165 ± 2,373 9,586 ± 2,976 Coronary hemodynamics MBF at rest 1.13 ± 0.19 1.09 ± 0.18 0.83 ± 0.15 0.61 ± 0.14 MBF at rest, corrected 1.18 ± 0.32 1.15 ± 0.27 0.91 ± 0.23 0.79 ± 0.22 Peak MBF during stress 2.81 ± 1.02 2.71 ± 1.11 1.72 ± 0.41 1.92 ± 0.28 CFR 2.51 ± 0.89 2.40 ± 0.96 2.00 ± 0.67 2.58 ± 0.68 CVR at rest 84.8 ± 23.5 85.1 ± 28.8 103.2 ± 44.7 102.1 ± 34.1 Peak CVR during stress 37.8 ± 16.0 36.9 ± 17.45 51.4 ± 19.6 41.9 ± 4.2 HR = heart rate, in bpm; BP = blood pressure, in mm Hg; CVR = coronary vascular resistance, which is calculated as mean arterial BP/MBF and reported in mm Hg/mL/g/min.
RPP is calculated as heart rate (in bpm) × systolic blood pressure (in mm Hg). MBF is reported in mL/g/min. CFR is calculated as peak MBF during stress/MBF at rest.
- TABLE 3
Per–Vascular Territory Analysis of Reproducibility of MBF, CFR, and Coronary Vascular Resistance (CVR)
82Rb visit 1 82Rb visit 2 Parameter LAD LOX RCA LAD LOX RCA MBF at rest 0.86 ± 0.16 0.89 ± 0.15 0.90 ± 0.18 0.83 ± 0.15 0.85 ± 0.15 0.87 ± 0.14 MBF at rest, corrected 0.91 ± 0.22 0.94 ± 0.20 0.95 ± 0.23 0.90 ± 0.23 0.92 ± 0.22 0.94 ± 0.20 Peak MBF during stress 1.87 ± 0.72 1.86 ± 0.66 1.92 ± 0.77 1.80 ± 0.63 1.84 ± 0.64 1.86 ± 0.64 CFR 2.10 ± 0.76 2.00 ± 0.61 2.09 ± 0.79 2.03 ± 0.65 2.04 ± 0.70 1.99 ± 0.61 CVR at rest 108.36 ± 34.74 103.84 ± 30.10 105.80 ± 38.63 110.04 ± 40.24 107.52 ± 39.99 104.56 ± 40.40 Peak CVR during stress 56.83 ± 23.35 56.17 ± 21.76 55.19 ± 21.38 53.16 ± 26.50 51.48 ± 24.04 50.42 ± 21.35 Data are reported as mean ± SD. MBF is reported in mL/g/min. CFR is calculated as peak MBF during stress/MBF at rest. CVR is calculated as mean arterial blood pressure/MBF and reported in mm Hg/mL/g/min.
- TABLE 4
Per–Vascular Territory Analysis of Accuracy of MBF, CFR, and Coronary Vascular Resistance (CVR)
82Rb 13N-ammonia Parameter LAD LOX RCA LAD LOX RCA MBF at rest 0.80 ± 0.13 0.82 ± 0.18 0.88 ± 0.18 0.61 ± 0.14 0.62 ± 0.18 0.60 ± 0.16 MBF at rest, corrected 0.90 ± 0.24 0.91 ± 0.25 0.98 ± 0.25 0.78 ± 0.22 0.81 ± 0.29 0.77 ± 0.22 Peak MBF during stress 1.70 ± 0.37 1.66 ± 0.36 1.82 ± 0.50 1.97 ± 0.33 1.89 ± 0.29 1.90 ± 0.30 CFR 2.01 ± 0.69 1.93 ± 0.65 1.97 ± 0.76 2.66 ± 0.72 2.55 ± 0.77 2.60 ± 0.64 CVR at rest 105.88 ± 48.38 103.95 ± 45.80 97.22 ± 44.38 102.88 ± 34.05 100.28 ± 36.87 106.92 ± 37.14 Peak CVR during stress 52.29 ± 20.88 52.86 ± 18.61 49.74 ± 19.86 40.48 ± 2.92 43.01 ± 5.17 42.41 ± 5.49 Data are reported as mean ± SD. MBF is reported in mL/g/min. CFR is calculated as peak MBF during stress/MBF at rest. CVR is calculated as mean arterial blood pressure/MBF and reported in mm Hg/mL/g/min.
- TABLE 5
Spearman ρ Nonparametric Correlations Among 82Rb PET Estimates of MBF Obtained by 4 Observers
Spearman ρ Observer 1 Observer 2 Observer 3 Observer 4 Observer 1 1.000 0.935* 0.845* 0.857* Observer 2 0.935* 1.000* 0.891* 0.890* Observer 3 0.845* 0.891* 1.000 0.827* Observer 4 0.857* 0.890* 0.827* 1.000 ↵* Correlation was significant at 0.01 level (2-tailed test).
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