No need for frame-wise attenuation correction in dynamic Rubidium-82 PET for myocardial blood flow quantification

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: Regadenoson-induced stress causes a repositioning of the heart, myocardial creep, in half of the patients undergoing Rubidium-82 (Rb-82) positron emission tomography (PET). As a result, misalignment of dynamic PET and computer tomography (CT) may occur, possibly affecting CT-based attenuation correction (AC) and thereby PET-based myocardial blood flow (MBF) quantification. Our aim was to determine the need for frame-wise PET-CT AC to obtain reliable MBF measurements.

    Methods: 31 Out of 64 consecutive patients had myocardial creep during regadenoson-induced stress Rb-82 PET-CT and were included. Prior to PET image reconstruction, we applied two AC methods; single PET-CT alignment and frame-wise alignment in which PET time-frames with myocardial creep were individually co-registered with CT. The PET-CT misalignment was then quantified and MBFs for the three vascular territories and whole myocardium were calculated and compared between both methods.

    Results: The magnitude of misalignment due to myocardial creep was 13.8 ± 4.5 mm in caudal-cranial direction, 1.8 ± 2.1 mm in medial-lateral and 2.5 ± 1.8 mm in anterior-posterior direction. Frame-wise PET-CT registration did not result in different MBF measurements (P ≥.07) and the magnitude of misalignment and MBF differences did not correlate (P ≥.58).

    Conclusion: There is no need for frame-wise AC in dynamic Rb-82 PET for MBF quantification. Single alignment seems sufficient in patients with myocardial creep.

    Original languageEnglish
    Pages (from-to)738-745
    Number of pages8
    JournalJournal of nuclear cardiology
    Issue number3
    Early online date21 Feb 2019
    Publication statusPublished - Jun 2019


    • UT-Hybrid-D
    • Myocardial blood flow
    • PET rubidium
    • PET-CT registration
    • Attenuation correction
    • 22/4 OA procedure

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