Incremental Diagnostic Value of Regional Myocardial Blood Flow Quantification Over Relative Perfusion Imaging With Generator-Produced Rubidium-82 PET

Keiichiro Yoshinaga; Chietsugu Katoh; Osamu Manabe; Ran Klein; Masanao Naya; Mamoru Sakakibara; Shiro Yamada; Robert A. deKemp; Hiroyuki Tsutsui; Nagara Tamaki

doi:10.1253/circj.CJ-11-0502

Imaging

Incremental Diagnostic Value of Regional Myocardial Blood Flow Quantification Over Relative Perfusion Imaging With Generator-Produced Rubidium-82 PET

Keiichiro Yoshinaga, Chietsugu Katoh, Osamu Manabe, Ran Klein, Masanao Naya, Mamoru Sakakibara, Shiro Yamada, Robert A. deKemp, Hiroyuki Tsutsui, Nagara Tamaki

Author information

Keiichiro Yoshinaga
Department of Photobiology, Hokkaido University Graduate School of Medicine
Chietsugu Katoh
Health Sciences, Hokkaido University Graduate School of Medicine
Osamu Manabe
Nuclear Medicine, Hokkaido University Graduate School of Medicine
Ran Klein
Nuclear Medicine, Hokkaido University Graduate School of Medicine
National Cardiac PET Centre, Division of Cardiology, University of Ottawa Heart Institute
Masanao Naya
Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
Mamoru Sakakibara
Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
Shiro Yamada
Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
Robert A. deKemp
National Cardiac PET Centre, Division of Cardiology, University of Ottawa Heart Institute
Hiroyuki Tsutsui
Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
Nagara Tamaki
Nuclear Medicine, Hokkaido University Graduate School of Medicine

Keywords: Blood flow, Coronary artery disease, Myocardial perfusion imaging, Positron emission tomography, Rubidium-82

JOURNAL FREE ACCESS

2011 Volume 75 Issue 11 Pages 2628-2634

DOI https://doi.org/10.1253/circj.CJ-11-0502

View "Advance Publication" version (August 27, 2011).

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Abstract

Background: Myocardial blood flow (MBF) can be measured with positron emission tomography (PET) and its quantification should provide diagnostic information beyond that obtained through standard visual analysis. However, this possibility has not been fully studied with PET and generator-produced rubidium-82 (⁸²Rb). We evaluated regional MBF in segments with and without ischemia using ⁸²Rb PET in patients with coronary artery disease (CAD). Methods and Results: Rest and stress ⁸²Rb PET and coronary angiography were performed for 12 patients with CAD. Based on angiography and relative ⁸²Rb perfusion images, segments were classified into 4 groups (Group A: myocardial ischemia with >70% diameter stenosis; Group B: no ischemia with stenosis; Group C: no ischemia without stenosis; Group D: ischemia without stenosis). Rest MBF was similar among the 4 groups. Groups A and B showed reduced hyperemic MBF compared with Group C (P<0.05 vs. Group C) [Group A (n=16) 1.28±0.58ml·min^-1·g^-1; Group B (n=11) 1.72±0.64ml·min^-1·g^-1; Group C (n=9) 2.60±1.09ml·min^-1·g^-1; Group D (n=2) 2.33ml·min^-1·g^-1]. Coronary flow reserves were inversely correlated with percent diameter stenosis (r=0.76, P<0.0001). Conclusions: Segments with ischemia and coronary stenosis had reduced hyperemic MBF. Segments with coronary stenosis without ischemia also had reduced hyperemic MBF compared with non-stenotic segments. MBF quantification using ⁸²Rb PET may provide additional diagnostic information. (Circ J 2011; 75: 2628-2634)

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