Abstract
Reliability of myocardial blood flow (MBF) quantification in myocardial perfusion imaging (MPI) using PET can majorly be affected by the occurrence of myocardial creep when using pharmacologically induced stress. In this paper, we provide instructions on how to detect and correct for myocardial creep. For example, in each time frame of the PET images the myocardium contour and the observed activity have to be compared to check for misalignments. In addition, we provide an overview of the functionality of commonly used software packages to perform this quality control step as not all software packages currently provide this functionality. Furthermore, important clinical considerations to obtain accurate MBF measurements are given.
Highlights
INTRODUCTIONWe observed a myocardial creep during regadenoson-induced stress in 52% of the 104 consecutively included patients.[4] In 83% of these 54 patients, myocardial creep resulted in a Myocardial blood flow (MBF) change [ 10%, which may influence diagnostic interpretation
Myocardial blood flow (MBF) quantification in myocardial perfusion imaging (MPI) using Rubidium-82 (Rb-82) PET provides valuable information about theJ Nucl Cardiol 2019;26:729–34. 1071-3581/$34.00 Copyright Ó 2019 The Author(s) extent and functional importance of possible stenosis.[1,2,3] the reliability of MBF quantification can be affected by the occurrence of myocardial creep, in particular during stress imaging.[4]
The reliability of MBF quantification can be affected by the occurrence of myocardial creep, in particular during stress imaging.[4]
Summary
We observed a myocardial creep during regadenoson-induced stress in 52% of the 104 consecutively included patients.[4] In 83% of these 54 patients, myocardial creep resulted in a MBF change [ 10%, which may influence diagnostic interpretation. Our study only comprised regadenoson-induced stress, the presence of myocardial creep is reported with adenosine as pharmacological vasodilator.[6] In a limited amount of patients (2%), myocardial creep can affect MBF quantification using rest imaging.[4] As MBF quantification can become biased when myocardial creep remains uncorrected, detection and correction are necessary for all pharmacological vasodilators and for both rest and stress scans. We show how myocardial creep can be detected and corrected. We provide an overview of the possibilities of commercially available software packages to detect and correct myocardial creep and highlight important clinical considerations
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