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Published in: Journal of Nuclear Cardiology 5/2012

01-10-2012 | Original Article

Short-term repeatability of resting myocardial blood flow measurements using rubidium-82 PET imaging

Authors: Matthew Efseaff, Ran Klein, PhD, Maria C. Ziadi, MD, Rob S. Beanlands, MD, FRCPC, FACC, Robert A. deKemp, PhD, PEng, PPhys

Published in: Journal of Nuclear Cardiology | Issue 5/2012

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Abstract

Background

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).

Methods

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.

Results

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.

Conclusion

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.
Literature
1.
go back to reference Ziadi M, Beanlands R. The clinical utility of assessing myocardial blood flow using positron emission tomography. J Nucl Cardiol 2010;17:571-81.PubMedCrossRef Ziadi M, Beanlands R. The clinical utility of assessing myocardial blood flow using positron emission tomography. J Nucl Cardiol 2010;17:571-81.PubMedCrossRef
2.
go back to reference Ziadi M, deKemp R, Williams K, Guo A, Renaud J, Chow B, et al. Does quantification of myocardial flow reserve using rubidium-82 positron emission tomography facilitate detection of multivessel coronary artery disease? J Nucl Med 2012;19(4):670–80. Ziadi M, deKemp R, Williams K, Guo A, Renaud J, Chow B, et al. Does quantification of myocardial flow reserve using rubidium-82 positron emission tomography facilitate detection of multivessel coronary artery disease? J Nucl Med 2012;19(4):670–80.
3.
go back to reference Parkash R, deKemp R, Ruddy T, Kitsikis A, Hart R, Beauschene L, et al. Potential utility of rubidium 82 PET quantification in patients with 3-vessel coronary artery disease. J Nucl Cardiol 2004;11:440-9.PubMedCrossRef Parkash R, deKemp R, Ruddy T, Kitsikis A, Hart R, Beauschene L, et al. Potential utility of rubidium 82 PET quantification in patients with 3-vessel coronary artery disease. J Nucl Cardiol 2004;11:440-9.PubMedCrossRef
4.
go back to reference Ziadi MC, deKemp RA, Williams KA, Guo A, Chow BJ, Renaud JM, et al. Imparied myocardial flow reserve on rubidium-82 positron emission tomography imaging predicts adverse outcomes in patients assessed for myocardial ischemia. J Am Coll Cardiol 2011;58:740-8.PubMedCrossRef Ziadi MC, deKemp RA, Williams KA, Guo A, Chow BJ, Renaud JM, et al. Imparied myocardial flow reserve on rubidium-82 positron emission tomography imaging predicts adverse outcomes in patients assessed for myocardial ischemia. J Am Coll Cardiol 2011;58:740-8.PubMedCrossRef
5.
go back to reference El Fakhri G, Kardan A, Sitek A, Dorbala S, Abi-Hatem N, Lahoud Y, et al. Reproducibility and accuracy of quantitative myocardial blood flow assessment with 82Rb PET: Comparison with 13N-ammonia PET. J Nucl Cardiol 2009;50:1062-71. El Fakhri G, Kardan A, Sitek A, Dorbala S, Abi-Hatem N, Lahoud Y, et al. Reproducibility and accuracy of quantitative myocardial blood flow assessment with 82Rb PET: Comparison with 13N-ammonia PET. J Nucl Cardiol 2009;50:1062-71.
6.
go back to reference Lautamäki R, George R, Kitagawa K, Higuchi T, Merrill J, Voicu C, et al. Rubidium-82 PET-CT for quantitative assessment of myocardial blood flow: Validation in a canine model of coronary artery stenosis. Eur J Nucl Med Mol Imaging 2009;36:576-86.PubMedCrossRef Lautamäki R, George R, Kitagawa K, Higuchi T, Merrill J, Voicu C, et al. Rubidium-82 PET-CT for quantitative assessment of myocardial blood flow: Validation in a canine model of coronary artery stenosis. Eur J Nucl Med Mol Imaging 2009;36:576-86.PubMedCrossRef
7.
go back to reference Klein R, Renaud J, Ziadi M, Thorn S, Adler A, Beanlands R, et al. Intra- and inter-operator repeatability of myocardial blood flow and myocardial flow reserve measurements using rubidium-82 and a highly automated analysis program. J Nucl Cardiol 2010;17:600-16.PubMedCrossRef Klein R, Renaud J, Ziadi M, Thorn S, Adler A, Beanlands R, et al. Intra- and inter-operator repeatability of myocardial blood flow and myocardial flow reserve measurements using rubidium-82 and a highly automated analysis program. J Nucl Cardiol 2010;17:600-16.PubMedCrossRef
8.
go back to reference Schindler T, Zhang X, Prior J, Dadenas J, Dahlbom M, Sayre J, et al. Assessment of intra- and interobserver reproducibility of rest and cold pressor test-stimulated myocardial blood flow with 13N-ammonia and PET. Eur J Nucl Med Mol Imaging 2007;34:1178-88.PubMedCrossRef Schindler T, Zhang X, Prior J, Dadenas J, Dahlbom M, Sayre J, et al. Assessment of intra- and interobserver reproducibility of rest and cold pressor test-stimulated myocardial blood flow with 13N-ammonia and PET. Eur J Nucl Med Mol Imaging 2007;34:1178-88.PubMedCrossRef
9.
go back to reference Kaufmann P, Gnecchi-Ruscone T, Yap J, Rimoldi O, Camici P. Assessment of the reproducibility of baseline and hyperemic myocardial blood flow measurements with 15O-labeled water and PET. J Nucl Med 1999;40:1848-56.PubMed Kaufmann P, Gnecchi-Ruscone T, Yap J, Rimoldi O, Camici P. Assessment of the reproducibility of baseline and hyperemic myocardial blood flow measurements with 15O-labeled water and PET. J Nucl Med 1999;40:1848-56.PubMed
10.
go back to reference Manabe O, Yoshinaga K, Katoh C, Naya M, deKemp R, Tamaki N. Repeatability of rest and hyperemic myocardial blood flow measurements with 82Rb dynamic PET. J Nucl Med 2009;50:68-71.PubMedCrossRef Manabe O, Yoshinaga K, Katoh C, Naya M, deKemp R, Tamaki N. Repeatability of rest and hyperemic myocardial blood flow measurements with 82Rb dynamic PET. J Nucl Med 2009;50:68-71.PubMedCrossRef
11.
go back to reference Klein R, Adler A, Beanlands R, deKemp R. Precision-controlled elution of a 82Sr/82Rb generator for cardiac perfusion imaging with positron emission tomography. Phys Med Biol 2007;52:659-73.PubMedCrossRef Klein R, Adler A, Beanlands R, deKemp R. Precision-controlled elution of a 82Sr/82Rb generator for cardiac perfusion imaging with positron emission tomography. Phys Med Biol 2007;52:659-73.PubMedCrossRef
12.
go back to reference Ruby-Fill™ Product Monograph. Rubidium Rb82 generator diagnostic radiopharmaceutical (myocardial imaging). Kirkland: Jubilant DraxImage Inc. Ruby-Fill™ Product Monograph. Rubidium Rb82 generator diagnostic radiopharmaceutical (myocardial imaging). Kirkland: Jubilant DraxImage Inc.
13.
go back to reference Lortie M, Beanlands R, Yoshinaga K, Klein R, DaSilva J, deKemp R. Quantification of myocardial blood flow with 82Rb dynamic PET imaging. Eur J Nucl Med Mol Imaging 2007;34:1765-74.PubMedCrossRef Lortie M, Beanlands R, Yoshinaga K, Klein R, DaSilva J, deKemp R. Quantification of myocardial blood flow with 82Rb dynamic PET imaging. Eur J Nucl Med Mol Imaging 2007;34:1765-74.PubMedCrossRef
14.
go back to reference Renkin E. Transport of potassium-42 from blood to tissue isolated mammalian skeletal muscles. Am J Physiol 1959;197:1205-10.PubMed Renkin E. Transport of potassium-42 from blood to tissue isolated mammalian skeletal muscles. Am J Physiol 1959;197:1205-10.PubMed
15.
go back to reference Crone C. Permeability of capillaries in various organs as determined by use of the indicator diffusion method. Acta Physiol Scand 1963;8:292-305.CrossRef Crone C. Permeability of capillaries in various organs as determined by use of the indicator diffusion method. Acta Physiol Scand 1963;8:292-305.CrossRef
16.
go back to reference Klein R, Katoh C, Yoshinaga K, Tamaki N, Adler A, Beanlands R, et al. Evaluation of myocardium to blood pool spillover correction in quantification myocardial blood flow with 82Rb PET [Poster]. Montreal: World Molecular Imaging Congress; 2009. Klein R, Katoh C, Yoshinaga K, Tamaki N, Adler A, Beanlands R, et al. Evaluation of myocardium to blood pool spillover correction in quantification myocardial blood flow with 82Rb PET [Poster]. Montreal: World Molecular Imaging Congress; 2009.
17.
go back to reference Hutchins G, Caraher J, Raylman R. A region of interest strategy for minimizing resolution distortions in quantitative myocardial PET studies. J Nucl Med 1992;3:1243-50. Hutchins G, Caraher J, Raylman R. A region of interest strategy for minimizing resolution distortions in quantitative myocardial PET studies. J Nucl Med 1992;3:1243-50.
18.
go back to reference Altman D, Bland J. Measurement in medicine: The analysis of method comparison studies. Statistician 1983:307-17. Altman D, Bland J. Measurement in medicine: The analysis of method comparison studies. Statistician 1983:307-17.
19.
go back to reference Slomka P, Alexanderson E, Jácome R, Jiménez M, Romero E, Meave A, et al. Comparison of clinical tools for measurements of regional stress and rest myocardial blood flow assessed with 13N-ammonia PET/CT. J Nucl Med 2012;53:171-81.PubMedCrossRef Slomka P, Alexanderson E, Jácome R, Jiménez M, Romero E, Meave A, et al. Comparison of clinical tools for measurements of regional stress and rest myocardial blood flow assessed with 13N-ammonia PET/CT. J Nucl Med 2012;53:171-81.PubMedCrossRef
20.
go back to reference Hove J, Iida H, Kofoed K, Freiberg J, Holm S, Kelbaek H. Left atrial versus left ventricular input function for quantification of the myocardial blood flow with nitrogen-13 ammonia and positron emission tomography. Eur J Nucl Med Mol Imaging 2004;31:71-6.PubMedCrossRef Hove J, Iida H, Kofoed K, Freiberg J, Holm S, Kelbaek H. Left atrial versus left ventricular input function for quantification of the myocardial blood flow with nitrogen-13 ammonia and positron emission tomography. Eur J Nucl Med Mol Imaging 2004;31:71-6.PubMedCrossRef
21.
go back to reference deKemp R, Slomka PJ, Declerck J, Pan XB, Klein R, Nakazato R, et al. Reproducible imaging of myocardial flow reserve with rubidium-82 PET—A multicentre multi-vendor comparison study. Eur Heart J 2011;13(suppl):A76. [abstract]. deKemp R, Slomka PJ, Declerck J, Pan XB, Klein R, Nakazato R, et al. Reproducible imaging of myocardial flow reserve with rubidium-82 PET—A multicentre multi-vendor comparison study. Eur Heart J 2011;13(suppl):A76. [abstract].
22.
go back to reference Wyss C, Koepfli P, Mikolajczyk K, Burger C, von Schulthess G, Kauffmann P. Bicycle exercise stress in PET for assessment of coronary flow reserve: Repeatability and comparison with adenosine stress. J Nucl Med 2003;44:146-54.PubMed Wyss C, Koepfli P, Mikolajczyk K, Burger C, von Schulthess G, Kauffmann P. Bicycle exercise stress in PET for assessment of coronary flow reserve: Repeatability and comparison with adenosine stress. J Nucl Med 2003;44:146-54.PubMed
23.
go back to reference Jagathesan R, Kaufmann P, Rosen S, Rimoldi O, Turkeimer F, Foale R, et al. Assessment of the long-term reproducibility of baseline and dobutamine-induced myocardial blood flow in patients with stable coronary artery disease. J Nucl Med 2005;46:212-9.PubMed Jagathesan R, Kaufmann P, Rosen S, Rimoldi O, Turkeimer F, Foale R, et al. Assessment of the long-term reproducibility of baseline and dobutamine-induced myocardial blood flow in patients with stable coronary artery disease. J Nucl Med 2005;46:212-9.PubMed
24.
go back to reference Chareonthaitawee P, Kaufmann P, Rimoldi O, Camici P. Heterogeneity of resting and hyperemic myocardial blood flow in healthy humans. Cardiovasc Res 2001;50:151-61.PubMedCrossRef Chareonthaitawee P, Kaufmann P, Rimoldi O, Camici P. Heterogeneity of resting and hyperemic myocardial blood flow in healthy humans. Cardiovasc Res 2001;50:151-61.PubMedCrossRef
25.
go back to reference Nagamachi S, Czernin J, Kim A, Sun K, Bottcher M, Phelps M, et al. Reproducibility of measurements of regional resting and hyperemic myocardial blood flow assessed with PET. J Nucl Med 1995;37:1626-31. Nagamachi S, Czernin J, Kim A, Sun K, Bottcher M, Phelps M, et al. Reproducibility of measurements of regional resting and hyperemic myocardial blood flow assessed with PET. J Nucl Med 1995;37:1626-31.
26.
go back to reference deKemp R, Klein R, Lortie M, Beanlands RS. Constant-activity-rate infusions for myocardial blood flow quantification with 82Rb and 3D PET. IEEE Nucl Sci Symp Conf Rec 2006;6:3519-21. deKemp R, Klein R, Lortie M, Beanlands RS. Constant-activity-rate infusions for myocardial blood flow quantification with 82Rb and 3D PET. IEEE Nucl Sci Symp Conf Rec 2006;6:3519-21.
Metadata
Title
Short-term repeatability of resting myocardial blood flow measurements using rubidium-82 PET imaging
Authors
Matthew Efseaff
Ran Klein, PhD
Maria C. Ziadi, MD
Rob S. Beanlands, MD, FRCPC, FACC
Robert A. deKemp, PhD, PEng, PPhys
Publication date
01-10-2012
Publisher
Springer-Verlag
Published in
Journal of Nuclear Cardiology / Issue 5/2012
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-012-9600-3

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