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Quantification of myocardial blood flow with (82)Rb positron emission tomography: clinical validation with (15)O-water
PURPOSE: Quantification of myocardial blood flow (MBF) with generator-produced (82)Rb is an attractive alternative for centres without an on-site cyclotron. Our aim was to validate (82)Rb-measured MBF in relation to that measured using (15)O-water, as a tracer 100% of which can be extracted from the...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer-Verlag
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3342496/ https://www.ncbi.nlm.nih.gov/pubmed/22398957 http://dx.doi.org/10.1007/s00259-012-2082-3 |
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author | Prior, John O. Allenbach, Gilles Valenta, Ines Kosinski, Marek Burger, Cyrill Verdun, Francis R. Bischof Delaloye, Angelika Kaufmann, Philipp A. |
author_facet | Prior, John O. Allenbach, Gilles Valenta, Ines Kosinski, Marek Burger, Cyrill Verdun, Francis R. Bischof Delaloye, Angelika Kaufmann, Philipp A. |
author_sort | Prior, John O. |
collection | PubMed |
description | PURPOSE: Quantification of myocardial blood flow (MBF) with generator-produced (82)Rb is an attractive alternative for centres without an on-site cyclotron. Our aim was to validate (82)Rb-measured MBF in relation to that measured using (15)O-water, as a tracer 100% of which can be extracted from the circulation even at high flow rates, in healthy control subject and patients with mild coronary artery disease (CAD). METHODS: MBF was measured at rest and during adenosine-induced hyperaemia with (82)Rb and (15)O-water PET in 33 participants (22 control subjects, aged 30 ± 13 years; 11 CAD patients without transmural infarction, aged 60 ± 13 years). A one-tissue compartment (82)Rb model with ventricular spillover correction was used. The (82)Rb flow-dependent extraction rate was derived from (15)O-water measurements in a subset of 11 control subjects. Myocardial flow reserve (MFR) was defined as the hyperaemic/rest MBF. Pearson’s correlation r, Bland-Altman 95% limits of agreement (LoA), and Lin’s concordance correlation ρ (c) (measuring both precision and accuracy) were used. RESULTS: Over the entire MBF range (0.66–4.7 ml/min/g), concordance was excellent for MBF (r = 0.90, [(82)Rb–(15)O-water] mean difference ± SD = 0.04 ± 0.66 ml/min/g, LoA = −1.26 to 1.33 ml/min/g, ρ (c) = 0.88) and MFR (range 1.79–5.81, r = 0.83, mean difference = 0.14 ± 0.58, LoA = −0.99 to 1.28, ρ (c) = 0.82). Hyperaemic MBF was reduced in CAD patients compared with the subset of 11 control subjects (2.53 ± 0.74 vs. 3.62 ± 0.68 ml/min/g, p = 0.002, for (15)O-water; 2.53 ± 1.01 vs. 3.82 ± 1.21 ml/min/g, p = 0.013, for (82)Rb) and this was paralleled by a lower MFR (2.65 ± 0.62 vs. 3.79 ± 0.98, p = 0.004, for (15)O-water; 2.85 ± 0.91 vs. 3.88 ± 0.91, p = 0.012, for (82)Rb). Myocardial perfusion was homogeneous in 1,114 of 1,122 segments (99.3%) and there were no differences in MBF among the coronary artery territories (p > 0.31). CONCLUSION: Quantification of MBF with (82)Rb with a newly derived correction for the nonlinear extraction function was validated against MBF measured using (15)O-water in control subjects and patients with mild CAD, where it was found to be accurate at high flow rates. (82)Rb-derived MBF estimates seem robust for clinical research, advancing a step further towards its implementation in clinical routine. |
format | Online Article Text |
id | pubmed-3342496 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | Springer-Verlag |
record_format | MEDLINE/PubMed |
spelling | pubmed-33424962012-05-16 Quantification of myocardial blood flow with (82)Rb positron emission tomography: clinical validation with (15)O-water Prior, John O. Allenbach, Gilles Valenta, Ines Kosinski, Marek Burger, Cyrill Verdun, Francis R. Bischof Delaloye, Angelika Kaufmann, Philipp A. Eur J Nucl Med Mol Imaging Original Article PURPOSE: Quantification of myocardial blood flow (MBF) with generator-produced (82)Rb is an attractive alternative for centres without an on-site cyclotron. Our aim was to validate (82)Rb-measured MBF in relation to that measured using (15)O-water, as a tracer 100% of which can be extracted from the circulation even at high flow rates, in healthy control subject and patients with mild coronary artery disease (CAD). METHODS: MBF was measured at rest and during adenosine-induced hyperaemia with (82)Rb and (15)O-water PET in 33 participants (22 control subjects, aged 30 ± 13 years; 11 CAD patients without transmural infarction, aged 60 ± 13 years). A one-tissue compartment (82)Rb model with ventricular spillover correction was used. The (82)Rb flow-dependent extraction rate was derived from (15)O-water measurements in a subset of 11 control subjects. Myocardial flow reserve (MFR) was defined as the hyperaemic/rest MBF. Pearson’s correlation r, Bland-Altman 95% limits of agreement (LoA), and Lin’s concordance correlation ρ (c) (measuring both precision and accuracy) were used. RESULTS: Over the entire MBF range (0.66–4.7 ml/min/g), concordance was excellent for MBF (r = 0.90, [(82)Rb–(15)O-water] mean difference ± SD = 0.04 ± 0.66 ml/min/g, LoA = −1.26 to 1.33 ml/min/g, ρ (c) = 0.88) and MFR (range 1.79–5.81, r = 0.83, mean difference = 0.14 ± 0.58, LoA = −0.99 to 1.28, ρ (c) = 0.82). Hyperaemic MBF was reduced in CAD patients compared with the subset of 11 control subjects (2.53 ± 0.74 vs. 3.62 ± 0.68 ml/min/g, p = 0.002, for (15)O-water; 2.53 ± 1.01 vs. 3.82 ± 1.21 ml/min/g, p = 0.013, for (82)Rb) and this was paralleled by a lower MFR (2.65 ± 0.62 vs. 3.79 ± 0.98, p = 0.004, for (15)O-water; 2.85 ± 0.91 vs. 3.88 ± 0.91, p = 0.012, for (82)Rb). Myocardial perfusion was homogeneous in 1,114 of 1,122 segments (99.3%) and there were no differences in MBF among the coronary artery territories (p > 0.31). CONCLUSION: Quantification of MBF with (82)Rb with a newly derived correction for the nonlinear extraction function was validated against MBF measured using (15)O-water in control subjects and patients with mild CAD, where it was found to be accurate at high flow rates. (82)Rb-derived MBF estimates seem robust for clinical research, advancing a step further towards its implementation in clinical routine. Springer-Verlag 2012-03-08 2012 /pmc/articles/PMC3342496/ /pubmed/22398957 http://dx.doi.org/10.1007/s00259-012-2082-3 Text en © The Author(s) 2012 https://creativecommons.org/licenses/by/4.0/ This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. |
spellingShingle | Original Article Prior, John O. Allenbach, Gilles Valenta, Ines Kosinski, Marek Burger, Cyrill Verdun, Francis R. Bischof Delaloye, Angelika Kaufmann, Philipp A. Quantification of myocardial blood flow with (82)Rb positron emission tomography: clinical validation with (15)O-water |
title | Quantification of myocardial blood flow with (82)Rb positron emission tomography: clinical validation with (15)O-water |
title_full | Quantification of myocardial blood flow with (82)Rb positron emission tomography: clinical validation with (15)O-water |
title_fullStr | Quantification of myocardial blood flow with (82)Rb positron emission tomography: clinical validation with (15)O-water |
title_full_unstemmed | Quantification of myocardial blood flow with (82)Rb positron emission tomography: clinical validation with (15)O-water |
title_short | Quantification of myocardial blood flow with (82)Rb positron emission tomography: clinical validation with (15)O-water |
title_sort | quantification of myocardial blood flow with (82)rb positron emission tomography: clinical validation with (15)o-water |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3342496/ https://www.ncbi.nlm.nih.gov/pubmed/22398957 http://dx.doi.org/10.1007/s00259-012-2082-3 |
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