RT Journal Article
SR Electronic
T1 Simulation of low dose protocols for myocardial perfusion 82Rubidium imaging
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP jnumed.120.252429
DO 10.2967/jnumed.120.252429
A1 Martin Lyngby Lassen
A1 Yuka Otaki
A1 Paul Kavanagh
A1 Robert Jack Henry Miller
A1 Daniel S. Berman
A1 Piotr J. Slomka
YR 2021
UL http://jnm.snmjournals.org/content/early/2021/01/08/jnumed.120.252429.abstract
AB 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±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.