title: Assessment of a protocol for routine simultaneous myocardial blood flow measurement and standard myocardial perfusion imaging with rubidium-82 on a high count rate positron emission tomography system.
abstract: OBJECTIVE
  High count rate positron emission tomography (PET) systems offer the potential for accurate myocardial blood flow (MBF) quantification during first-pass dynamic imaging in conjunction with standard rubidium-82 (Rb-82) PET myocardial perfusion imaging (MPI). We investigate the feasibility of this using a Siemens Biograph mCT.
  
  
  METHODS
  Current routine clinical PET MPI is performed with 1480 MBq (40 mCi) Rb-82. Dynamic first-pass images from 217 consecutive patients were reviewed for evidence of detector saturation, indicating that count rate limits had been exceeded. Phantom acquisitions in the presence of high count rates were performed to assess the effect of detector saturation on quantitative accuracy.
  
  
  RESULTS
  Accurate MBF quantification and perfusion imaging using current protocols was successful in 85% of clinical cases. Detector block saturation was observed in 15% of cases, and phantom acquisitions indicate that saturation may have an adverse effect on quantitative accuracy. Visualization of transit or pooling of Rb-82 in the vessels in the axilla was the most consistent feature when saturation occurred. Reduction of administered activity to 1110 MBq (30 mCi) and subsequent evaluation of 159 patients ensured successful MBF quantification while maintaining good diagnostic quality perfusion imaging in 99% of cases.
  
  
  CONCLUSIONS
  MBF quantification and good-quality standard perfusion imaging can be performed on a high count rate PET system using a single-acquisition protocol. The administered activity requires optimization and we recommend 1110 MBq for PET MPI with a Biograph mCT.
authors: Nuclear Medicine Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK. deborah.tout@cmft.nhs.uk
authors: Deborah
authors: D
authors: Tout
authors: Christine M
authors: CM
authors: Tonge
authors: Sivakumar
authors: S
authors: Muthu
authors: Parthiban
authors: P
authors: Arumugam
mesh_terms: D055424:Cardiac-Gated Imaging Techniques; D005240:Feasibility Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D055414:Myocardial Perfusion Imaging / Q000295:instrumentation / Q000379:methods*; D056888:Patient Positioning; D049268:Positron-Emission Tomography / Q000295:instrumentation / Q000379:methods*; D012039:Regional Blood Flow; D012414:Rubidium Radioisotopes; D013326:Strontium Radioisotopes; D013997:Time Factors
chemical_list: D012414:Rubidium Radioisotopes; D013326:Strontium Radioisotopes