@article {Lassenjnumed.120.252429, author = {Martin Lyngby Lassen and Yuka Otaki and Paul Kavanagh and Robert Jack Henry Miller and Daniel S. Berman and Piotr J. Slomka}, title = {Simulation of low dose protocols for myocardial perfusion 82Rubidium imaging}, elocation-id = {jnumed.120.252429}, year = {2021}, doi = {10.2967/jnumed.120.252429}, publisher = {Society of Nuclear Medicine}, abstract = {Purpose: Quantification of myocardial perfusion and myocardial blood flow using Rubidium-82 (82Rb) positron emission tomography (PET) is increasingly utilized for assessment of coronary artery disease (CAD). Current guidelines suggest injections of 1100-1500MBq. Reducing the injected dose avoids PET system saturation in first-pass flow images and reduces radiation exposure, but the impact on myocardial perfusion quantification on static perfusion images is not fully understood. In this study, we aimed to evaluate the feasibility of performing myocardial perfusion scans using either a half-dose (HfD) or quarter dose (QD) protocol using reconstructions from acquired full-dose (FD) scans. Methods: This study comprised 171 patients who underwent rest/stress 82Rb PET with a 3D 4-ring PET/CT scanner using a FD protocol and invasive coronary angiography within 6 months of the PET emission scan. HfD and QD reconstructions were obtained by using the prescribed percentage of events from the FD listmode files. Total perfusion deficit for rest (rTPD), stress (sTPD) and ischemia (ITPD = sTPD-rTPD) were quantified. Diagnostic accuracy for obstructive CAD, defined as stenosis >=70\% in any of the three major coronary arteries, was compared with area under the receiver operating characteristic curve (AUC). Results: Patients with a median BMI of 28.0 (Inter quartile range = 23.9-31.7) were injected with doses of 1,165{\textpm}189 MBq 82Rb. For sTPD, FD and HfD protocols had similar AUC (FD = 0.807, HfD = 0.802, P = 0.108), whereas QD had reduced AUC (0.786, P = 0.037). There was no difference in AUC obtained for ITPD among the three protocols (AUC: FD=0.831, HfD = 0.835, QD = 0.831, all p>=0.805). Conclusion: Half-dose imaging does not affect the quantitative diagnostic accuracy of 82Rb PET on 3D PET/CT systems and could be used clinically.}, issn = {0161-5505}, URL = {https://jnm.snmjournals.org/content/early/2021/01/08/jnumed.120.252429}, eprint = {https://jnm.snmjournals.org/content/early/2021/01/08/jnumed.120.252429.full.pdf}, journal = {Journal of Nuclear Medicine} }