Positron imaging of myocardial infarction with rubidium-82

Positron imaging provides tomographic images of regional myocardial perfusion but has required an on-site cyclotron. Rubidium-82 (82Rb) is a short-lived (T1/2 = 75 sec) positron emitter available from a generator. In order to determine the feasibility for its use to image acute myocardial infarction, 18 patients with transmural infarctions who had coronary arteriography were given 30-40 mCi of 82Rb intravenously and positron tomographic imaging was carried out within 96 hr after onset of symptoms. Nine simultaneous transaxial slices were obtained for each patient with a positron camera. Images were also reconstructed in a long-axis, short-axis, and three-dimensional display. One study could not be interpreted because of excessive lung activity. Fourteen normals were also studied. The infarct related artery determined by angiography was correctly diagnosed by positron imaging in all 17 patients as were all three prior infarcts by readers blinded to the clinical data. No defects were observed in normals or in noninfarcted myocardial regions. This study indicates that 82Rb should be useful for perfusion imaging in patients with acute myocardial infarction. The short half-life of 82Rb should make it ideal for providing serial assessment of perfusion in patients undergoing thrombolytic therapy.