PT - JOURNAL ARTICLE AU - R. Glenn Wells AU - Lihui Wei AU - Julia Petryk AU - Yin Duan AU - Brian Marvin AU - Rachel Timmins AU - Karen Soueidan AU - Pasan Fernando AU - Corinne Bensimon AU - Terrence D. Ruddy TI - Flow-Dependent Uptake of <sup>123</sup>I-CMICE-013, a Novel SPECT Perfusion Agent, Compared with Standard Tracers AID - 10.2967/jnumed.114.151563 DP - 2015 May 01 TA - Journal of Nuclear Medicine PG - 764--770 VI - 56 IP - 5 4099 - http://jnm.snmjournals.org/content/56/5/764.short 4100 - http://jnm.snmjournals.org/content/56/5/764.full SO - J Nucl Med2015 May 01; 56 AB - Rotenone derivatives have shown promise in myocardial perfusion imaging (MPI). CMICE-013 is a novel 123I-labeled rotenone derivative developed for SPECT MPI. The objective of this study was to assess the image quality of CMICE-013 and compare its uptake with tetrofosmin, sestamibi, and 201Tl in vivo in a porcine model of stress-induced myocardial ischemia. Methods: Microspheres were injected simultaneously with the radiotracer injections at rest and stress to measure blood flow. Mimicking a 1-d tetrofosmin protocol, stress imaging used 3 times as much activity and occurred 1 h after the rest injection. SPECT images were obtained at both rest and stress. After imaging, the heart was sectioned into 44–50 pieces. In each heart sample, the tracer uptake was measured in a γ counter. The images were aligned, and the decay-corrected ratio of the signals at rest and stress was used to separate the well-counter signal into rest and stress components. The uptake at rest and stress was compared with microsphere flow measurements. Results: The CMICE-013 images showed good contrast between the heart and surrounding organs, with heart-to-liver and heart-to-lung uptake ratios similar to those of the standard tracers. Uptake of CMICE-013 was 1.5% of the injected dose at rest and increased more rapidly with increased blood flow than did the standard SPECT tracers. The percentage injected dose of CMICE-013 taken up by the heart was greater (P &lt; 0.05) than 201Tl, tetrofosmin, or sestamibi at flows greater than 1.5 mL/min/g. Conclusion: CMICE-013 is a promising new SPECT MPI agent.