Abstract
Myocardial blood flow (MBF) and flow reserve are usually quantified in the clinic with positron emission tomography (PET) using a perfusion-specific radiotracer (e.g. 82Rb-chloride). However, the clinical accessibility of existing perfusion tracers remains limited. Meanwhile, 18F-fluorodeoxyglucose (FDG) is a commonly used radiotracer for PET metabolic imaging without similar limitations. In this paper, we explore the potential of 18F-FDG for myocardial perfusion imaging by comparing the myocardial FDG delivery rate K 1 with MBF as determined by dynamic 82Rb PET in fourteen human subjects with heart disease. Two sets of FDG K 1 were derived from one-hour dynamic FDG scans. One was the original FDG K 1 estimates and the other was the corresponding K 1 values that were linearly normalized for blood glucose levels. A generalized Renkin-Crone model was used to fit FDG K 1 with Rb MBF, which then allowed for a nonlinear extraction fraction correction for converting FDG K 1 to MBF. The linear correlation between FDG-derived MBF and Rb MBF was moderate (r = 0.79) before the glucose normalization and became much improved (r > 0.9) after glucose normalization. The extraction fraction of FDG was also similar to that of Rb-chloride in the myocardium. The results from this pilot study suggest that dynamic cardiac FDG-PET with tracer kinetic modeling has the potential to provide MBF in addition to its conventional use for metabolic imaging.
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