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Published on: December 28, 2013
Incremental diagnostic value of regional myocardial blood flow quantification over relative perfusion imaging with
Keiichiro Yoshinaga1, Chietsugu Katoh, Osamu Manabe
1Department of Photobiology, Hokkaido University Graduate School of Medicine, Japan. kyoshi@med.hokudai.ac.jp
Background:
Myocardial blood flow (MBF) can be measured with positron emission tomography (PET) and its quantification should provide diagnostic information beyond that obtained through standard visual analysis. However, this possibility has not been fully studied with PET and generator-produced rubidium-82 (⁸²Rb). We evaluated regional MBF in segments with and without ischemia using ⁸²Rb PET in patients with coronary artery disease (CAD).
Methods And Results:
Rest and stress ⁸²Rb PET and coronary angiography were performed for 12 patients with CAD. Based on angiography and relative ⁸²Rb perfusion images, segments were classified into 4 groups (Group A: myocardial ischemia with >70% diameter stenosis; Group B: no ischemia with stenosis; Group C: no ischemia without stenosis; Group D: ischemia without stenosis). Rest MBF was similar among the 4 groups. Groups A and B showed reduced hyperemic MBF compared with Group C (P < 0.05 vs. Group C) [Group A (n=16) 1.28 ± 0.58 ml·min⁻¹·g⁻¹; Group B (n=11) 1.72 ± 0.64 ml·min⁻¹·g⁻¹; Group C (n=9) 2.60 ± 1.09 ml·min⁻¹·g⁻¹; Group D (n=2) 2.33 ml·min⁻¹·g⁻¹]. Coronary flow reserves were inversely correlated with percent diameter stenosis (r=0.76, P < 0.0001).
Conclusions:
Segments with ischemia and coronary stenosis had reduced hyperemic MBF. Segments with coronary stenosis without ischemia also had reduced hyperemic MBF compared with non-stenotic segments. MBF quantification using ⁸²Rb PET may provide additional diagnostic information.
Insights
Quantifying myocardial blood flow (MBF) with rubidium-82 (⁸²Rb) PET reveals reduced flow in segments with coronary stenosis, even without ischemia. This ⁸²Rb PET method may offer diagnostic insights beyond visual analysis for coronary artery disease (CAD).
Area of Science:
- Cardiovascular Imaging
- Nuclear Cardiology
- Myocardial Perfusion Imaging
Background:
- Myocardial blood flow (MBF) quantification using positron emission tomography (PET) holds potential for improved diagnosis in coronary artery disease (CAD).
- The diagnostic utility of generator-produced rubidium-82 (⁸²Rb) PET for MBF quantification, particularly in relation to ischemic segments, requires further investigation.
Purpose of the Study:
- To evaluate regional MBF using ⁸²Rb PET in patients with CAD.
- To compare MBF in myocardial segments with and without ischemia and coronary stenosis.
Main Methods:
- 12 patients with CAD underwent rest and stress ⁸²Rb PET and coronary angiography.
- Myocardial segments were categorized based on the presence of ischemia and degree of coronary stenosis.
- Regional MBF was quantified at rest and during hyperemia.
Main Results:
- Segments with ischemia and >70% stenosis (Group A) and segments with stenosis but no ischemia (Group B) exhibited reduced hyperemic MBF compared to non-stenotic segments (Group C).
- Rest MBF did not significantly differ across the groups.
- Coronary flow reserves showed a significant inverse correlation with the percentage of diameter stenosis (r=0.76, P < 0.0001).
Conclusions:
- Reduced hyperemic MBF is present in myocardial segments with both ischemia and coronary stenosis, as well as in segments with stenosis but without evident ischemia.
- MBF quantification with ⁸²Rb PET may provide valuable diagnostic information beyond standard visual assessment for CAD.
