Short-term repeatability of resting myocardial blood flow measurements using rubidium-82 PET imaging
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Rubidium-82 (82Rb) PET imaging has been proposed for routine myocardial blood flow (MBF) quantification. However, few studies have investigated the test-retest repeatability of this method. The aim of this study was to optimize same-day repeatability of rest MBF imaging with a highly automated analysis program (FlowQuant) using image-derived input functions and dual spillover corrections (SOC).
Test-retest repeatability of resting left-ventricle (LV) MBF was measured in patients (n = 27) with suspected coronary artery disease (CAD) and healthy volunteers (n = 9). The effects of scan-time, reconstruction, and quantification methods were assessed with correlation and Bland-Altman repeatability coefficients.
Factors affecting rest MBF included gender, suspected CAD, and SOC (P < .001). Significant test-retest correlations were found using all analysis methods tested (r > 0.79). The best repeatability coefficient for same-day MBF was 0.20 mL/minute/g using a 6-minute scan-time, iterative reconstruction, SOC, resting rate-pressure-product (RPP) adjustment, and left atrium input function. This protocol was significantly less variable than standard protocols using filtered back-projection reconstruction, longer scan-time, no SOC, or LV input function.
Absolute MBF can be measured with good repeatability using FlowQuant analysis of 82Rb PET scans with a 6-minute scan time, iterative reconstruction, dual SOC, RPP-adjustment, and an image-derived input function in the left atrium cavity.
KeywordsRubidium-82 PET myocardial blood flow myocardial perfusion imaging test-retest repeatability
The authors would like to thank Judy Etele for enrolling the study subjects, and May Aung and Kimberly Gardner for performing the PET scans. This study was supported by an Imaging in Cardiovascular Therapeutics grant from the Ontario Research Fund (RE02038), and a Molecular Function and Imaging Program grant from the Heart and Stroke Foundation of Ontario (PRG6242). Matthew Efseaff was supported in part by an Ontario Graduate Scholarship.
Conflict of interest
Robert deKemp, Ran Klein, and Rob Beanlands are consultants for Jubilant DRAXimage. Robert deKemp and Ran Klein share revenues from the sale of FlowQuant.
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