TY - JOUR T1 - Absolute Quantitation of Myocardial Blood Flow in Human Subjects With or Without Myocardial Ischemia Using Dynamic Flurpiridaz F 18 PET JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 1438 LP - 1444 DO - 10.2967/jnumed.114.141093 VL - 55 IS - 9 AU - René R.S. Packard AU - Sung-Cheng Huang AU - Magnus Dahlbom AU - Johannes Czernin AU - Jamshid Maddahi Y1 - 2014/09/01 UR - http://jnm.snmjournals.org/content/55/9/1438.abstract N2 - Absolute quantitation of myocardial blood flow (MBF) by PET is an established method of analyzing coronary artery disease (CAD) but subject to the various shortcomings of available radiotracers. Flurpiridaz F 18 is a novel PET radiotracer that exhibits properties of an ideal tracer. Methods: A new absolute perfusion quantitation method with flurpiridaz was developed, taking advantage of the early kinetics and high first-pass extraction by the myocardium of this radiotracer, and the first-in-human measurements of MBF performed in 7 healthy subjects and 8 patients with documented CAD. PET images with time–activity curves were acquired at rest and during adenosine stress. Results: In healthy subjects, regional MBF between coronary artery territories did not differ significantly, leading to a mean global MBF of 0.73 mL/min/g at rest and 2.53 mL/min/g during stress, with a mean global myocardial flow reserve (MFR) of 3.70. CAD vascular territories with <50% stenosis demonstrated a mean MBF of 0.73 at rest and 2.02 during stress, leading to a mean MFR of 2.97. CAD vascular territories with ≥50% stenosis exhibited a mean MBF of 0.86 at rest and 1.43 during stress, leading to a mean MFR of 1.86. Differences in stress MBF and MFR between normal and CAD territories, as well as between <50% and ≥50% stenosis vascular territories, were significant (P < 0.01). Conclusion: Absolute quantitation of MBF in humans with the novel PET radiotracer flurpiridaz is feasible over a wide range of cardiac flow in the presence or absence of stress-inducible myocardial ischemia. The significant decrease in stress MBF and ensuing MFR in CAD territories allows a clear distinction between vascular territories exhibiting stress-inducible myocardial ischemia and those with normal perfusion. ER -