The utility of 82 Rb PET for myocardial viability assessment: Comparison with perfusion-metabolism 82 Rb- 18 F-FDG PET

Jonathan B. Moody*, Keri M. Hiller, Benjamin C. Lee, Alexis Poitrasson-Rivière, James R. Corbett, Richard L. Weinberg, Venkatesh L. Murthy, Edward P. Ficaro

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Background: 82 Rb kinetics may distinguish scar from viable but dysfunctional (hibernating) myocardium. We sought to define the relationship between 82 Rb kinetics and myocardial viability compared with conventional 82 Rb and 18 F-fluorodeoxyglucose (FDG) perfusion-metabolism PET imaging. Methods: Consecutive patients (N = 120) referred for evaluation of myocardial viability prior to revascularization and normal volunteers (N = 37) were reviewed. Dynamic 82 Rb 3D PET data were acquired at rest. 18 F-FDG 3D PET data were acquired after metabolic preparation using a standardized hyperinsulinemic-euglycemic clamp. 82 Rb kinetic parameters K 1 , k 2 , and partition coefficient (KP) were estimated by compartmental modeling Results: Segmental 82 Rb k 2 and KP differed significantly between scarred and hibernating segments identified by Rb-FDG perfusion-metabolism (k 2 , 0.42 ± 0.25 vs. 0.22 ± 0.09 min −1 ; P <.0001; KP, 1.33 ± 0.62 vs. 2.25 ± 0.98 ml/g; P <.0001). As compared to Rb-FDG analysis, segmental Rb KP had a c-index, sensitivity and specificity of 0.809, 76% and 84%, respectively, for distinguishing hibernating and scarred segments. Segmental k 2 performed similarly, but with lower specificity (75%, P <.001) Conclusions: In this pilot study, 82 Rb kinetic parameters k 2 and KP, which are readily estimated using a compartmental model commonly used for myocardial blood flow, reliably differentiated hibernating myocardium and scar. Further study is necessary to evaluate their clinical utility for predicting benefit after revascularization.

Original languageEnglish (US)
Pages (from-to)374-386
Number of pages13
JournalJournal of Nuclear Cardiology
Volume26
Issue number2
DOIs
StatePublished - Apr 15 2019
Externally publishedYes

Keywords

  • cardiac rubidium-82 3D PET
  • hibernating myocardium
  • Ischemic cardiomyopathy
  • kinetic modeling

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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