Quantitative Myocardial Blood Flow with Rubidium-82 PET: a Clinical Perspective

Overview

Journal Am J Nucl Med Mol Imaging

Date 2015 Nov 10

PMID 26550537

Citations 14

Authors

Christoffer E Hagemann

Adam A Ghotbi

Andreas Kjaer

Philip Hasbak

Affiliations

Soon will be listed here.

Abstract

Positron emission tomography (PET) allows assessment of myocardial blood flow in absolute terms (ml/min/g). Quantification of myocardial blood flow (MBF) and myocardial flow reserve (MFR) extend the scope of conventional semi-quantitative myocardial perfusion imaging (MPI): e.g. in 1) identification of the extent of a multivessel coronary artery disease (CAD) burden, 2) patients with balanced 3-vessel CAD, 3) patients with subclinical CAD, and 4) patients with regional flow variance, despite of a high global MFR. A more accurate assessment of the ischemic burden in patients with intermediate pretest probability of CAD can support the clinical decision-making in treatment of CAD patients as a complementary tool to the invasive coronary angiography (CAG). Recently, several studies have proven Rubidium-82 ((82)Rb) PET's long-term prognostic value by a significant association between compromised global MFR and major adverse cardiovascular events (MACE), and together with new diagnostic possibilities from measuring the longitudinal myocardial perfusion gradient, cardiac (82)Rb PET faces a promising clinical future. This article reviews current evidence on quantitative (82)Rb PET's ability to diagnose and risk stratify CAD patients, while assessing the potential of the modality in clinical practice.

Citing Articles

Coronary Microvascular Dysfunction Years After Cessation of Anabolic Androgenic Steroid Use.

Bulut Y, Rasmussen J, Brandt-Jacobsen N, Frystyk J, Thevis M, Schou M JAMA Netw Open. 2024; 7(12):e2451013.

PMID: 39680410 PMC: 11650407. DOI: 10.1001/jamanetworkopen.2024.51013.

Casting aside the creep: harnessing cardiorespiratory dynamics to optimize myocardial flow assessment in cardiac PET.

Lima B, Benz D J Nucl Cardiol. 2023; 30(6):2301-2302.

PMID: 37731013 DOI: 10.1007/s12350-023-03376-3.

New Insights in Early Detection of Anticancer Drug-Related Cardiotoxicity Using Perfusion and Metabolic Imaging.

Cadour F, Thuny F, Sourdon J Front Cardiovasc Med. 2022; 9:813883.

PMID: 35198613 PMC: 8858802. DOI: 10.3389/fcvm.2022.813883.

Clinical implications of compromised Rb PET data acquisition.

Van Tosh A, Cao J, Votaw J, Cooke C, Palestro C, Nichols K J Nucl Cardiol. 2021; 29(5):2583-2594.

PMID: 34417670 DOI: 10.1007/s12350-021-02774-9.

Advances in translational imaging of the microcirculation.

Guerraty M, Bhargava A, Senarathna J, Mendelson A, Pathak A Microcirculation. 2021; 28(3):e12683.

PMID: 33524206 PMC: 8647298. DOI: 10.1111/micc.12683.

References

Gould K . Does coronary flow trump coronary anatomy?. JACC Cardiovasc Imaging. 2009; 2(8):1009-23. DOI: 10.1016/j.jcmg.2009.06.004. View

Fukushima K, Javadi M, Higuchi T, Lautamaki R, Merrill J, Nekolla S . Prediction of short-term cardiovascular events using quantification of global myocardial flow reserve in patients referred for clinical 82Rb PET perfusion imaging. J Nucl Med. 2011; 52(5):726-32. DOI: 10.2967/jnumed.110.081828. View

Merhige M, Breen W, Shelton V, Houston T, DArcy B, Perna A . Impact of myocardial perfusion imaging with PET and (82)Rb on downstream invasive procedure utilization, costs, and outcomes in coronary disease management. J Nucl Med. 2007; 48(7):1069-76. DOI: 10.2967/jnumed.106.038323. View

Christensen T, Bang L, Holmvang L, Ghotbi A, Lassen M, Andersen F . Cardiac ⁹⁹mTc sestamibi SPECT and ¹⁸F FDG PET as viability markers in Takotsubo cardiomyopathy. Int J Cardiovasc Imaging. 2014; 30(7):1407-16. DOI: 10.1007/s10554-014-0453-5. View

Prior J, Allenbach G, Valenta I, Kosinski M, Burger C, Verdun F . Quantification of myocardial blood flow with 82Rb positron emission tomography: clinical validation with 15O-water. Eur J Nucl Med Mol Imaging. 2012; 39(6):1037-47. PMC: 3342496. DOI: 10.1007/s00259-012-2082-3. View

Anagnostopoulos C, Georgakopoulos A, Pianou N, Nekolla S . Assessment of myocardial perfusion and viability by positron emission tomography. Int J Cardiol. 2013; 167(5):1737-49. DOI: 10.1016/j.ijcard.2012.12.009. View

Gould K, Johnson N, Bateman T, Beanlands R, Bengel F, Bober R . Anatomic versus physiologic assessment of coronary artery disease. Role of coronary flow reserve, fractional flow reserve, and positron emission tomography imaging in revascularization decision-making. J Am Coll Cardiol. 2013; 62(18):1639-1653. DOI: 10.1016/j.jacc.2013.07.076. View

Ghotbi A, Kjaer A, Hasbak P . Review: comparison of PET rubidium-82 with conventional SPECT myocardial perfusion imaging. Clin Physiol Funct Imaging. 2013; 34(3):163-70. PMC: 4204510. DOI: 10.1111/cpf.12083. View

Lortie M, Beanlands R, Yoshinaga K, Klein R, DaSilva J, deKemp R . Quantification of myocardial blood flow with 82Rb dynamic PET imaging. Eur J Nucl Med Mol Imaging. 2007; 34(11):1765-74. DOI: 10.1007/s00259-007-0478-2. View

10.

Sampson U, Dorbala S, Limaye A, Kwong R, Di Carli M . Diagnostic accuracy of rubidium-82 myocardial perfusion imaging with hybrid positron emission tomography/computed tomography in the detection of coronary artery disease. J Am Coll Cardiol. 2007; 49(10):1052-8. DOI: 10.1016/j.jacc.2006.12.015. View

11.

Hutchins G, Schwaiger M, Rosenspire K, Krivokapich J, Schelbert H, Kuhl D . Noninvasive quantification of regional blood flow in the human heart using N-13 ammonia and dynamic positron emission tomographic imaging. J Am Coll Cardiol. 1990; 15(5):1032-42. DOI: 10.1016/0735-1097(90)90237-j. View

12.

Saraste A, Kajander S, Han C, Nesterov S, Knuuti J . PET: Is myocardial flow quantification a clinical reality?. J Nucl Cardiol. 2012; 19(5):1044-59. DOI: 10.1007/s12350-012-9588-8. View

13.

Knesaurek K, Machac J, Zhang Z . Repeatability of regional myocardial blood flow calculation in 82Rb PET imaging. BMC Med Phys. 2009; 9:2. PMC: 2646684. DOI: 10.1186/1756-6649-9-2. View

14.

Gould K, Nakagawa Y, Nakagawa K, Sdringola S, Hess M, Haynie M . Frequency and clinical implications of fluid dynamically significant diffuse coronary artery disease manifest as graded, longitudinal, base-to-apex myocardial perfusion abnormalities by noninvasive positron emission tomography. Circulation. 2000; 101(16):1931-9. DOI: 10.1161/01.cir.101.16.1931. View

15.

Valenta I, Dilsizian V, Quercioli A, Ruddy T, Schindler T . Quantitative PET/CT measures of myocardial flow reserve and atherosclerosis for cardiac risk assessment and predicting adverse patient outcomes. Curr Cardiol Rep. 2013; 15(3):344. DOI: 10.1007/s11886-012-0344-0. View

16.

Farhad H, Dunet V, Bachelard K, Allenbach G, Kaufmann P, Prior J . Added prognostic value of myocardial blood flow quantitation in rubidium-82 positron emission tomography imaging. Eur Heart J Cardiovasc Imaging. 2013; 14(12):1203-10. DOI: 10.1093/ehjci/jet068. View

17.

Chow B, Dennie C, Hoffmann U, So D, de Kemp R, Ruddy T . Comparison of computed tomographic angiography versus rubidium-82 positron emission tomography for the detection of patients with anatomical coronary artery disease. Can J Cardiol. 2007; 23(10):801-7. PMC: 2651386. DOI: 10.1016/s0828-282x(07)70831-0. View

18.

Reddy K, Yusuf S . Emerging epidemic of cardiovascular disease in developing countries. Circulation. 1998; 97(6):596-601. DOI: 10.1161/01.cir.97.6.596. View

19.

Tout D, Davidson G, Hurley C, Bartley M, Arumugam P, Bradley A . Comparison of occupational radiation exposure from myocardial perfusion imaging with Rb-82 PET and Tc-99m SPECT. Nucl Med Commun. 2014; 35(10):1032-7. DOI: 10.1097/MNM.0000000000000160. View

20.

Montalescot G, Sechtem U, Andreotti F, Arden C, Budaj A, Bugiardini R . 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J. 2013; 34(38):2949-3003. DOI: 10.1093/eurheartj/eht296. View