Impact of regadenoson-induced myocardial creep on dynamic Rubidium-82 PET myocardial blood flow quantification

S.S. Koenders*, J.D. van Dijk, P.L. Jager, J.P. Ottervanger, C.H. Slump, J.A. van Dalen

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

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    Background: Repositioning of the heart during myocardial perfusion imaging (MPI) using Rubidium-82 (Rb-82) PET may occur when using regadenoson. Our aim was to determine the prevalence and the effect of correcting for this myocardial creep on myocardial blood flow (MBF) quantification. Methods: We retrospectively included 119 consecutive patients who underwent dynamic rest- and regadenoson-induced stress MPI using Rb-82 PET. The presence of myocardial creep was visually assessed in the dynamic stress PET series by identifying differences between the automatically drawn myocardium contour and the activity. Uncorrected and corrected stress MBFs were compared for the three vascular territories (LAD, LCX, and RCA) and for the whole myocardium. Results: Myocardial creep was observed in 52% of the patients during stress. Mean MBF values decreased after correction in the RCA from 4.0 to 2.7 mL/min/g (P < 0.001), in the whole myocardium from 2.7 to 2.6 mL/min/g (P = 0.01), and increased in the LAD from 2.5 to 2.6 mL/min/g (P = 0.03) and remained comparable in the LCX (P = 0.3). Conclusions: Myocardial creep is a frequent phenomenon when performing regadenoson-induced stress Rb-82 PET and has a significant impact on MBF values, especially in the RCA territory. As this may hamper diagnostic accuracy, myocardial creep correction seems necessary for reliable quantification.

    Original languageEnglish
    Pages (from-to)719-728
    Number of pages10
    JournalJournal of nuclear cardiology
    Issue number3
    Early online date20 Feb 2019
    Publication statusPublished - Jun 2019


    • UT-Hybrid-D
    • Myocardial blood flow
    • Myocardial creep
    • PET myocardial perfusion imaging
    • Regadenoson
    • Rb


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