K. Yoshida et al., CORONARY FLOW AND FLOW RESERVE BY PET SIMPLIFIED FOR CLINICAL-APPLICATIONS USING RB-82 OR NITROGEN-13-AMMONIA, The Journal of nuclear medicine, 37(10), 1996, pp. 1701-1712
To validate routine, noninvasive determination of absolute myocardial
perfusion and coronary flow reserve (CFR), cardiac PET was performed i
n animals using a simplified imaging protocol, high-dose dipyridamole
and a simplified quantitative algorithm specific for Rb-82 and N-13-am
monia. Methods: One hundred thirty-five PET scans were obtained in eig
ht dogs after intravenous N-13-ammonia or Rb-82 using serial dynamic P
ET or a simple two-image dataset. A simple flow model using the two-im
age dataset was developed for each radionuclide to account for varying
arterial input function, flow-dependent myocardial extraction and inc
reased permeability surface area (PS) product due to capillary recruit
ment at high flows not incorporated into previous models. Myocardial p
erfusion by the simple model was compared to standard, complete, two-c
ompartment kinetic models validated by comparison to electromagnetic f
low meter. Results: For N-13-ammonia, myocardial perfusion by the simp
le PET model correlated with that by complete compartmental analysis o
f multiple serial PET images with r=0.94, slope=0.96; CFR by compartme
ntal analysis correlated with CFR by electromagnetic Row meter with r=
0.94, slope=0.97. For Rb-82, myocardial perfusion determined by the si
mple model correlated with that determined by complete compartmental a
nalysis of multiple serial PET images with r=0.98, slope=1.06; CFR det
ermined by compartmental analysis correlated with CFR by electromagnet
ic flow meter with r=0.88, slope=1.13. Conclusion: A simplified PET pr
otocol using N-13-ammonia or Rb-82 and simple flow models provide noni
nvasive measurement of CFR up to six times baseline flow throughout th
e heart and diagnostic image quality for routine clinical application.