Quantification of myocardial blood flow with 82Rb PET demonstrated excellent concordance with 15O-water PET over the entire flow range (ρc=0.88), validating its accuracy for clinical use even at high flow rates.
Cross-Sectional (n=33)
Single-blind
Yes
Does 82Rb PET accurately quantify myocardial blood flow and flow reserve compared to 15O-water PET in healthy controls and patients with mild CAD?
82Rb PET with a newly derived correction for nonlinear extraction accurately quantifies myocardial blood flow and flow reserve compared to the 15O-water gold standard.
Effect estimate: Lin's concordance correlation ρc 0.88 (95% CI 0.82-0.94)
PURPOSE: Quantification of myocardial blood flow (MBF) with generator-produced (82)Rb is an attractive alternative for centres without an on-site cyclotron. Our aim was to validate (82)Rb-measured MBF in relation to that measured using (15)O-water, as a tracer 100% of which can be extracted from the circulation even at high flow rates, in healthy control subject and patients with mild coronary artery disease (CAD). METHODS: MBF was measured at rest and during adenosine-induced hyperaemia with (82)Rb and (15)O-water PET in 33 participants (22 control subjects, aged 30 ± 13 years; 11 CAD patients without transmural infarction, aged 60 ± 13 years). A one-tissue compartment (82)Rb model with ventricular spillover correction was used. The (82)Rb flow-dependent extraction rate was derived from (15)O-water measurements in a subset of 11 control subjects. Myocardial flow reserve (MFR) was defined as the hyperaemic/rest MBF. Pearson's correlation r, Bland-Altman 95% limits of agreement (LoA), and Lin's concordance correlation ρ (c) (measuring both precision and accuracy) were used. RESULTS: Over the entire MBF range (0.66-4.7 ml/min/g), concordance was excellent for MBF (r = 0.90, (82)Rb-(15)O-water mean difference ± SD = 0.04 ± 0.66 ml/min/g, LoA = -1.26 to 1.33 ml/min/g, ρ(c) = 0.88) and MFR (range 1.79-5.81, r = 0.83, mean difference = 0.14 ± 0.58, LoA = -0.99 to 1.28, ρ(c) = 0.82). Hyperaemic MBF was reduced in CAD patients compared with the subset of 11 control subjects (2.53 ± 0.74 vs. 3.62 ± 0.68 ml/min/g, p = 0.002, for (15)O-water; 2.53 ± 1.01 vs. 3.82 ± 1.21 ml/min/g, p = 0.013, for (82)Rb) and this was paralleled by a lower MFR (2.65 ± 0.62 vs. 3.79 ± 0.98, p = 0.004, for (15)O-water; 2.85 ± 0.91 vs. 3.88 ± 0.91, p = 0.012, for (82)Rb). Myocardial perfusion was homogeneous in 1,114 of 1,122 segments (99.3%) and there were no differences in MBF among the coronary artery territories (p > 0.31). CONCLUSION: Quantification of MBF with (82)Rb with a newly derived correction for the nonlinear extraction function was validated against MBF measured using (15)O-water in control subjects and patients with mild CAD, where it was found to be accurate at high flow rates. (82)Rb-derived MBF estimates seem robust for clinical research, advancing a step further towards its implementation in clinical routine.
Prior et al. (Wed,) conducted a cross-sectional in Coronary Artery Disease (n=33). 82Rb positron emission tomography vs. 15O-water positron emission tomography was evaluated on Concordance of myocardial blood flow (MBF) measurements between 82Rb and 15O-water (Lin's concordance correlation ρc 0.88, 95% CI 0.82-0.94). Quantification of myocardial blood flow with 82Rb PET demonstrated excellent concordance with 15O-water PET over the entire flow range (ρc=0.88), validating its accuracy for clinical use even at high flow rates.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: