Generator-produced rubidium-82 positron emission tomography myocardial perfusion imaging-From basic aspects to clinical applications.
ABSTRACT Cardiovascular disease is the leading cause of death in modern industrialized countries with an aging population. This fact has fueled the need for innovative diagnostic testing intended to improve coronary artery disease (CAD) patient care. Detection of myocardial ischemia using myocardial perfusion imaging (MPI) plays an important role for CAD diagnosis and the prediction of future risk of cardiovascular events. Positron emission tomography (PET) MPI has high diagnostic accuracy and can estimate regional myocardial blood flow (MBF) in patients with CAD. Rubidium-82 ((82)Rb) is a generator-produced PET myocardial perfusion tracer and has been widely used in North America in clinical practice. (82)Rb PET has recently become available in some cardiovascular centers in Europe and Japan. Clinical trials are expected in both regions. (82)Rb PET has high diagnostic accuracy and recent data have shown its prognostic value. Thus, (82)Rb PET would greatly contribute to CAD patients' care. (82)Rb PET can also be used to quantify MBF. This review describes the current status of (82)Rb MPI from basic principles to clinical implications. This paper also highlights the recent development of MBF quantification using (82)Rb PET.
Article: Quantification of regional myocardial blood flow estimation with three-dimensional dynamic rubidium-82 PET and modified spillover correction model.[show abstract] [hide abstract]
ABSTRACT: Myocardial blood flow (MBF) estimation with (82)Rubidium ((82)Rb) positron emission tomography (PET) is technically difficult because of the high spillover between regions of interest, especially due to the long positron range. We sought to develop a new algorithm to reduce the spillover in image-derived blood activity curves, using non-uniform weighted least-squares fitting. Fourteen volunteers underwent imaging with both 3-dimensional (3D) (82)Rb and (15)O-water PET at rest and during pharmacological stress. Whole left ventricular (LV) (82)Rb MBF was estimated using a one-compartment model, including a myocardium-to-blood spillover correction to estimate the corresponding blood input function Ca(t)(whole). Regional K1 values were calculated using this uniform global input function, which simplifies equations and enables robust estimation of MBF. To assess the robustness of the modified algorithm, inter-operator repeatability of 3D (82)Rb MBF was compared with a previously established method. Whole LV correlation of (82)Rb MBF with (15)O-water MBF was better (P < .01) with the modified spillover correction method (r = 0.92 vs r = 0.60). The modified method also yielded significantly improved inter-operator repeatability of regional MBF quantification (r = 0.89) versus the established method (r = 0.82) (P < .01). A uniform global input function can suppress LV spillover into the image-derived blood input function, resulting in improved precision for MBF quantification with 3D (82)Rb PET.Journal of Nuclear Cardiology 04/2012; 19(4):763-74. · 2.67 Impact Factor