title: Absolute quantitation of myocardial blood flow in human subjects with or without myocardial ischemia using dynamic flurpiridaz F 18 PET.
abstract: Absolute quantitation of myocardial blood flow (MBF) by PET is an established method of analyzing coronary artery disease (CAD) but subject to the various shortcomings of available radiotracers. Flurpiridaz F 18 is a novel PET radiotracer that exhibits properties of an ideal tracer.
  
  
  METHODS
  A new absolute perfusion quantitation method with flurpiridaz was developed, taking advantage of the early kinetics and high first-pass extraction by the myocardium of this radiotracer, and the first-in-human measurements of MBF performed in 7 healthy subjects and 8 patients with documented CAD. PET images with time-activity curves were acquired at rest and during adenosine stress.
  
  
  RESULTS
  In healthy subjects, regional MBF between coronary artery territories did not differ significantly, leading to a mean global MBF of 0.73 mL/min/g at rest and 2.53 mL/min/g during stress, with a mean global myocardial flow reserve (MFR) of 3.70. CAD vascular territories with <50% stenosis demonstrated a mean MBF of 0.73 at rest and 2.02 during stress, leading to a mean MFR of 2.97. CAD vascular territories with ≥50% stenosis exhibited a mean MBF of 0.86 at rest and 1.43 during stress, leading to a mean MFR of 1.86. Differences in stress MBF and MFR between normal and CAD territories, as well as between <50% and ≥50% stenosis vascular territories, were significant (P < 0.01).
  
  
  CONCLUSIONS
  Absolute quantitation of MBF in humans with the novel PET radiotracer flurpiridaz is feasible over a wide range of cardiac flow in the presence or absence of stress-inducible myocardial ischemia. The significant decrease in stress MBF and ensuing MFR in CAD territories allows a clear distinction between vascular territories exhibiting stress-inducible myocardial ischemia and those with normal perfusion.
authors: Department of Medicine (Cardiology), University of California, Los Angeles, California; and.
authors: René R S
authors: RR
authors: Packard
authors: Department of Molecular and Medical Pharmacology (Nuclear Medicine), Ronald Reagan UCLA Medical Center, University of California, Los Angeles, California.
authors: Sung-Cheng
authors: SC
authors: Huang
authors: Department of Molecular and Medical Pharmacology (Nuclear Medicine), Ronald Reagan UCLA Medical Center, University of California, Los Angeles, California.
authors: Magnus
authors: M
authors: Dahlbom
authors: Department of Molecular and Medical Pharmacology (Nuclear Medicine), Ronald Reagan UCLA Medical Center, University of California, Los Angeles, California.
authors: Johannes
authors: J
authors: Czernin
authors: Department of Medicine (Cardiology), University of California, Los Angeles, California; and Department of Molecular and Medical Pharmacology (Nuclear Medicine), Ronald Reagan UCLA Medical Center, University of California, Los Angeles, California jmaddahi@mednet.ucla.edu.
authors: Jamshid
authors: J
authors: Maddahi
mesh_terms: D000368:Aged; D003326:Coronary Circulation; D005260:Female; D005462:Fluorine Radioisotopes; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000503:physiopathology*; D049268:Positron-Emission Tomography / Q000379:methods*; D011724:Pyridazines
chemical_list: C525920:BMS 747158-02; D005462:Fluorine Radioisotopes; D011724:Pyridazines
keywords: MBF; MFR; PET; flurpiridaz; human