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06-01-2023 | Positron Emission Tomography | ORIGINAL ARTICLE

Splenic switch-off in regadenoson ⁸²Rb-PET myocardial perfusion imaging: assessment of clinical utility

Authors: Jean Michel Saad, MD, Ahmed Ibrahim Ahmed, MD MPH, Yushui Han, MS, Lamees I. El Nihum, BS, Fares Alahdab, MD MSc, Faisal Nabi, MD, Mouaz H. Al-Mallah, MD MSc

Published in: Journal of Nuclear Cardiology | Issue 4/2023

Abstract

Background

Splenic switch-off (SSO) is a phenomenon describing a decrease in splenic radiotracer uptake after vasodilatory stress. We aimed to assess the diagnostic utility of regadenoson-induced SSO.

Methods

We included consecutive patients who had clinically indicated Regadenoson Rb-82 PET-MPI for suspected CAD. This derivation cohort (no perfusion defects and myocardial flow reserves (MFR) ≥ 2) was used to calculate the splenic response ratio (SRR). The validation cohort was defined as patients who underwent both PET-MPI studies and invasive coronary angiography (ICA).

Results

The derivation cohort (n = 100, 57.4 ± 11.6 years, 77% female) showed a decrease in splenic uptake from rest to stress (79.9 ± 16.8 kBq⋅mL vs 69.1 ± 16.2 kBq⋅mL, P < .001). From the validation cohort (n = 315, 66.3 ± 10.4 years, 67% male), 28% (via SRR = 0.88) and 15% (visually) were classified as splenic non-responders. MFR was lower in non-responders (SRR; 1.55 ± 0.65 vs 1.76 ± 0.78, P = .02 and visually; 1.18 ± 0.33 vs 1.79 ± 0.77, P < .001). Based on ICA, non-responders were more likely to note obstructive epicardial disease with normal PET scans especially in patients with MFR < 1.5 (SRR; 61% vs 34% P = .05 and visually; 68% vs 33%, P = .01).

Conclusion

Lack of splenic response based on visual or quantitative assessment of SSO may be used to identify an inadequate vasodilatory response.

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Title: Splenic switch-off in regadenoson 82Rb-PET myocardial perfusion imaging: assessment of clinical utility
Authors: Jean Michel Saad, MD
Ahmed Ibrahim Ahmed, MD MPH
Yushui Han, MS
Lamees I. El Nihum, BS
Fares Alahdab, MD MSc
Faisal Nabi, MD
Mouaz H. Al-Mallah, MD MSc
Publication date: 06-01-2023
Publisher: Springer International Publishing
Keyword: Positron Emission Tomography
Published in: Journal of Nuclear Cardiology / Issue 4/2023
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI: https://doi.org/10.1007/s12350-022-03158-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Splenic switch-off in regadenoson ⁸²Rb-PET myocardial perfusion imaging: assessment of clinical utility

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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