Abstract
BackgroundRepositioning of the heart during myocardial perfusion imaging (MPI) using Rubidium-82 (Rb-82) PET may occur when using regadenoson. Our aim was to determine the prevalence and the effect of correcting for this myocardial creep on myocardial blood flow (MBF) quantification. MethodsWe retrospectively included 119 consecutive patients who underwent dynamic rest- and regadenoson-induced stress MPI using Rb-82 PET. The presence of myocardial creep was visually assessed in the dynamic stress PET series by identifying differences between the automatically drawn myocardium contour and the activity. Uncorrected and corrected stress MBFs were compared for the three vascular territories (LAD, LCX, and RCA) and for the whole myocardium. ResultsMyocardial creep was observed in 52% of the patients during stress. Mean MBF values decreased after correction in the RCA from 4.0 to 2.7 mL/min/g (P < 0.001), in the whole myocardium from 2.7 to 2.6 mL/min/g (P = 0.01), and increased in the LAD from 2.5 to 2.6 mL/min/g (P = 0.03) and remained comparable in the LCX (P = 0.3). ConclusionsMyocardial creep is a frequent phenomenon when performing regadenoson-induced stress Rb-82 PET and has a significant impact on MBF values, especially in the RCA territory. As this may hamper diagnostic accuracy, myocardial creep correction seems necessary for reliable quantification.
Highlights
The use of myocardial blood flow (MBF) quantification using Rubidium-82 (Rb-82) in myocardial perfusion imaging (MPI) with positron emission tomography (PET) is increasing rapidly.[1,2,3] MPI using Rb-82 PET is of added value in the diagnosis of coronary artery disease, and the MBF quantification provides valuable additional prognostic information about the extent and functional importance of possible stenosis.[4,5,6]A dynamic PET acquisition including the capture of the first-pass bolus of the activity is required for MBF quantification
Mean MBF values decreased after correction in the right coronary (RCA) from 4.0 to 2.7 mL/min/g (P
We have demonstrated that a myocardial creep occurs in more than half of the patients during regadenoson-induced stress MPI using Rb-82 PET
Summary
The use of myocardial blood flow (MBF) quantification using Rubidium-82 (Rb-82) in myocardial perfusion imaging (MPI) with positron emission tomography (PET) is increasing rapidly.[1,2,3] MPI using Rb-82 PET is of added value in the diagnosis of coronary artery disease, and the MBF quantification provides valuable additional prognostic information about the extent and functional importance of possible stenosis.[4,5,6]A dynamic PET acquisition including the capture of the first-pass bolus of the activity is required for MBF quantification. The use of myocardial blood flow (MBF) quantification using Rubidium-82 (Rb-82) in myocardial perfusion imaging (MPI) with positron emission tomography (PET) is increasing rapidly.[1,2,3] MPI using Rb-82 PET is of added value in the diagnosis of coronary artery disease, and the MBF quantification provides valuable additional prognostic information about the extent and functional importance of possible stenosis.[4,5,6]. Repositioning of the heart during myocardial perfusion imaging (MPI) using Rubidium-82 (Rb-82) PET may occur when using regadenoson. Our aim was to determine the prevalence and the effect of correcting for this myocardial creep on myocardial blood flow (MBF) quantification
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