Journal of Nuclear Cardiology

, Volume 25, Issue 2, pp 596–605 | Cite as

The impact of prompt gamma compensation on myocardial blood flow measurements with rubidium-82 dynamic PET

  • Ian S. Armstrong
  • Matthew J. Memmott
  • Christine M. Tonge
  • Parthiban Arumugam
Original Article

Abstract

Background

Rubidium-82 myocardial perfusion imaging is a well-established technique for assessing myocardial ischemia. With continuing interest on myocardial blood flow (MBF) and myocardial flow reserve (MFR) measurements, there is a requirement to fully appreciate the impact of technical aspects of the process. One such factor for rubidium-82 is prompt gamma compensation (PGC). This study aims to assess the impact of PGC on MBF and MFR calculated from dynamic Rb-82 data.

Methods

Dynamic rest and stress images were acquired on a Siemens Biograph mCT and reconstructed with and without PGC in 50 patients (29 male). MBF and MFR were measured in the three main coronary territories as well as globally.

Results

With PGC, statistically significant reductions in MBF were observed in LAD (−6.9%), LCx (−4.8%), and globally (−6.5%) but only in obese patients. Significant increases in MBF were observed in RCA (+6.4%) in only nonobese patients. In very obese patients, differences of up to 40% in MBF were observed between PGC and non-PGC images. In nearly all cases, similar PGC differences were observed at stress and rest so there were no significant differences in MFR; however, in a small number of very obese patients, differences in excess of 20% were observed.

Conclusion

PGC results in statistically significant changes in MBF, with the greatest reductions observed in the LAD and LCx territories of obese patients. In most cases, the impact on stress and rest data is of similar relative magnitudes and changes to MFR are small.

Keywords

PET/CT imaging coronary flow reserve PET image reconstruction physics of imaging 

Abbreviations

BIF

Blood input function

CAD

Coronary artery disease

LAD

Left anterior descending coronary artery

LCx

Left circumflex coronary artery

MBF

Myocardial blood flow

MFR

Myocardial flow reserve

PET

Positron emission tomography

PGC

Prompt gamma compensation

RCA

Right coronary artery

Notes

Disclosures

There are no conflicts of interest for Ian Armstrong, Matthew Memmott, Christine Tonge, and Parthiban Arumugam associated with this study.

Supplementary material

12350_2016_583_MOESM1_ESM.ppt (1.1 mb)
Supplementary material 1 (PPT 1144 kb)

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Copyright information

© American Society of Nuclear Cardiology 2016

Authors and Affiliations

  • Ian S. Armstrong
    • 1
  • Matthew J. Memmott
    • 1
  • Christine M. Tonge
    • 1
  • Parthiban Arumugam
    • 1
  1. 1.Nuclear MedicineCentral Manchester University HospitalsManchesterUnited Kingdom

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