Properties of Radiotracers Used for PET MBF Quantification
| Property | 82Rb-chloride | 13N-ammonia | 15O-water | 18F-flurpiridaz |
| Isotope production method | Generator | Cyclotron | Cyclotron | Cyclotron |
| Isotope half-life (min) | 1.27 | 10 | 2.0 | 110 |
| Positron range (mm) RMS | 2.6 | 0.57 | 1.0 | 0.23 |
| Image resolution (mm) FWHM | 8 | 5 | 6 | 5 |
| Effective dose (mSv/GBq) | 1 | 2 | 1 | 20 |
| Peak stress/rest* extraction (%) | 35/70 | 95/100 | 100 | 95/100 |
| Peak stress/rest* retention (%) | 25/70 | 50/90 | 0 | 55/90 |
| Spillover from adjacent organs | Stomach wall | Liver and lung | Liver | Early liver |
| Regulatory status | FDA-approved; 2 suppliers | FDA-approved; ANDA required for onsite production | Not FDA-approved | Phase 3 trials partially completed |
| Typical rest dose for 3D/2D (mCi†) | 30/45 | 10/15 | 20/30 | 2/3 |
| Typical stress dose for 3D/2D (mCi†) | 30/45 | 10/15 | 20/30 | 6/7 |
| Protocol features | Rapid protocol | Permits exercise‡; delay of 4–5 half-lives between rest and stress unless different doses used | Rapid protocol; no tracer retention for routine MPI | Permits exercise‡; different doses for rest and stress required |
↵* Peak stress = 3–4 mL/min/g, rest = 0.75–1.0 mL/min/g.
↵† 1 mCi = 37 MBq.
↵‡ Exercise protocols do not allow quantification of MBF.
RMS = root mean square (standard) deviation; FWHM = full width at half maximum achievable using PET scanner with 5-mm spatial resolution; FDA = Food and Drug Administration; ANDA = abbreviated new drug application.