Minimizing rubidium-82 tracer activity for relative PET myocardial perfusion imaging

Eline D. Huizing, Joris D. van Dijk*, Jorn A. van Dalen, Jorik R. Timmer, Hester Arkies, Cees H. Slump, Pieter L. Jager

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

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    Objectives: Recommended rubidium-82 activities for relative myocardial perfusion imaging (MPI) using present-generation PET scanners may be unnecessarily high. Our aim was to derive the minimum activity for a reliable relative PET MPI assessment.
    Materials and methods: We analyzed 140 scans from 28 consecutive patients who underwent rest-stress MPI-PET (Ingenuity TF). Scans of 852, 682, 511, and 341 MBq were simulated from list-mode data and compared with a reference scan using 1023 MBq. Differences in the summed rest score, total perfusion deficit, and image quality were obtained between the reference and each of the simulated rest scans. Combined stress-rest scans obtained at a selected activity of 682 MBq were diagnostically interpreted by experts and outcome was compared with the reference scan interpretation.

    Differences in summed rest score more than or equal to 3 were found using 682, 511, and 341 MBq in two (7%), four (14%), and five (18%) patients, respectively. Differences in total perfusion deficit more than 7% were only found at 341 MBq in one patient. Image quality deteriorated significantly only for the 341 MBq scans (P<0.001). Interpretation of stress-rest scans did not differ between 682 and 1023 MBq scans.
    A significant reduction in administered Rb-82 activity is feasible in relative MPI. An activity of 682 MBq resulted in reliable diagnostic outcomes and image quality, and can therefore be considered for clinical adoption.
    Original languageEnglish
    Pages (from-to)708-714
    Number of pages7
    JournalNuclear medicine communications
    Issue number8
    Publication statusPublished - Aug 2017


    • Lutetium oxy orthosilicate
    • Myocardial perfusion imaging
    • PET computed tomography
    • Radiation dosage
    • Rubidium
    • 2023 OA procedure

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