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- Title
The utility of <sup>82</sup>Rb PET for myocardial viability assessment: Comparison with perfusion-metabolism <sup>82</sup>Rb-<sup>18</sup>F-FDG PET.
- Authors
Moody, Jonathan B.; Hiller, Keri M.; Lee, Benjamin C.; Poitrasson-Rivière, Alexis; Corbett, James R.; Weinberg, Richard L.; Murthy, Venkatesh L.; Ficaro, Edward P.
- Abstract
<bold>Background: </bold>82Rb kinetics may distinguish scar from viable but dysfunctional (hibernating) myocardium. We sought to define the relationship between 82Rb kinetics and myocardial viability compared with conventional 82Rb and 18F-fluorodeoxyglucose (FDG) perfusion-metabolism PET imaging.<bold>Methods: </bold>Consecutive patients (N = 120) referred for evaluation of myocardial viability prior to revascularization and normal volunteers (N = 37) were reviewed. Dynamic 82Rb 3D PET data were acquired at rest. 18F-FDG 3D PET data were acquired after metabolic preparation using a standardized hyperinsulinemic-euglycemic clamp. 82Rb kinetic parameters K1, k2, and partition coefficient (KP) were estimated by compartmental modeling RESULTS: Segmental 82Rb k2 and KP differed significantly between scarred and hibernating segments identified by Rb-FDG perfusion-metabolism (k2, 0.42 ± 0.25 vs. 0.22 ± 0.09 min-1; P < .0001; KP, 1.33 ± 0.62 vs. 2.25 ± 0.98 ml/g; P < .0001). As compared to Rb-FDG analysis, segmental Rb KP had a c-index, sensitivity and specificity of 0.809, 76% and 84%, respectively, for distinguishing hibernating and scarred segments. Segmental k2 performed similarly, but with lower specificity (75%, P < .001) CONCLUSIONS: In this pilot study, 82Rb kinetic parameters k2 and KP, which are readily estimated using a compartmental model commonly used for myocardial blood flow, reliably differentiated hibernating myocardium and scar. Further study is necessary to evaluate their clinical utility for predicting benefit after revascularization.
- Subjects
BLOOD flow; PILOT projects
- Publication
Journal of Nuclear Cardiology, 2019, Vol 26, Issue 2, p374
- ISSN
1071-3581
- Publication type
journal article
- DOI
10.1007/s12350-019-01615-0