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Dependency of cardiac rubidium-82 imaging quantitative measures on age, gender, vascular territory, and software in a cardiovascular normal population

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Objectives

Recent technological improvements to PET imaging equipment combined with the availability of software optimized to calculate regional myocardial blood flow (MBF) and myocardial flow reserve (MFR) create a paradigm shifting opportunity to provide new clinically relevant quantitative information to cardiologists. However, clinical interpretation of the MBF and MFR is entirely dependent upon knowledge of MBF and MFR values in normal populations and subpopulations. This work reports Rb-82-based MBF and MFR measurements for a series of 49 verified cardiovascularly normal subjects as a preliminary baseline for future clinical studies.

Methods

Forty-nine subjects (24F/25M, ages 41-69) with low probability for coronary artery disease and with normal exercise stress test were included. These subjects underwent rest/dipyridamole stress Rb-82 myocardial perfusion imaging using standard clinical techniques (40 mCi injection, 6-minute acquisition) using a Siemens Biograph 40 PET/CT scanner with high count rate detector option. List mode data was rehistogrammed into 26 dynamic frames (12 × 5 seconds, 6 × 10 seconds, 4 × 20 seconds, 4 × 40 seconds). Cardiac images were processed, and MBF and MFR calculated using Siemens syngo MBF, PMOD, and FlowQuant software using a single compartment Rb-82 model.

Results

Global myocardial blood flow under pharmacological stress for the 24 females as measured by PMOD, syngo MBF, and FlowQuant were 3.10 ± 0.72, 2.80 ± 0.66, and 2.60 ± 0.63 mL·minute−1·g−1, and for the 25 males was 2.60 ± 0.84, 2.33 ± 0.75, 2.15 ± 0.62 mL·minute−1·g−1, respectively. Rest flows for PMOD, syngo MBF, and FlowQuant averaged 1.32 ± 0.42, 1.20 ± 0.33, and 1.06 ± 0.38 mL·minute−1·g−1 for the female subjects, and 1.12 ± 0.29, 0.90 ± 0.26, and 0.85 ± 0.24 mL·minute−1·g−1 for the males. Myocardial flow reserves for PMOD, syngo MBF, and FlowQuant for the female normals were calculated to be 2.50 ± 0.80, 2.53 ± 0.67, 2.71 ± 0.90, and 2.50 ± 1.19, 2.85 ± 1.19, 2.94 ± 1.31 mL·minute−1·g−1 for males.

Conclusion

Quantitative normal MBF and MFR values averaged for age and sex have been compiled for three commercial pharmacokinetic software packages. The current collection of data consisting of 49 subjects resulted in several statistically significant conclusions that support the need for a software specific, age, and sex-matched database to aid in interpretation of quantitative clinical myocardial perfusion studies.

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Disclosure

First Author (Sunderland) received research funding from Siemens Medical Solutions for the performance of the research presented. Drs. Pan and Declerck are employees of Siemens Molecular Imaging, the IP holders for one of the pieces of software tested and presented. Dr. Pan was involved in early processing of the data for syngo MBF in earlier software versions and provided technical modeling support. Both Drs. Pan and Declerck were involved in editing the manuscript.

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Authors and Affiliations

  1. Department of Radiology, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA

    John J. Sunderland PhD & Yusuf Menda MD

  2. Siemens Molecular Imaging, Oxford, UK

    Xiao-Bo Pan PhD & Jerome Declerck PhD

Authors
  1. John J. Sunderland PhD
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  2. Xiao-Bo Pan PhD
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  3. Jerome Declerck PhD
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  4. Yusuf Menda MD
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Corresponding author

Correspondence to John J. Sunderland PhD.

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Funding

This project was funded, in part, by Siemens Molecular Imaging.

See related editorial, doi: 10.1007/s12350-014-0007-1.

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Sunderland, J.J., Pan, XB., Declerck, J. et al. Dependency of cardiac rubidium-82 imaging quantitative measures on age, gender, vascular territory, and software in a cardiovascular normal population. J. Nucl. Cardiol. 22, 72–84 (2015). https://doi.org/10.1007/s12350-014-9920-6

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  • DOI: https://doi.org/10.1007/s12350-014-9920-6

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