Washout of 82Rb as a marker of impaired tissue integrity, obtained by list-mode cardiac PET/CT

Relationship with perfusion/metabolism patterns of myocardial viability

David T. Chien, Paco Bravo, Takahiro Higuchi, Jennifer Merrill, Frank M. Bengel

Research output: Contribution to journalArticle

Abstract

Purpose Myocardial washout of the potassium analogue 82Rb may indicate tissue impairment. Few studies have evaluated its usefulness for viability assessment, and controversial results were reported. We revisited this topic using list-mode positron emission tomography (PET)/CT. Methods A total of 22 patients with chronic ischemic cardiomyopathy (ICM) and 11 control subjects with normal CT coronary angiogram were studied. Rest 82Rb PET/CT studies were acquired in list mode and resampled to static, gated, and dynamic images. Using a 17-segment model, 82Rb washout was determined by monoexponential fitting of myocardial time-activity curves. In ICM patients, 18Ffluorodeoxyglucose (FDG) studies were obtained in the same session and segments were classified as normally perfused, mismatch, or matched defect. Results 82Rb washout was minimal and homogeneous in control subjects. Normally perfused segments of ICM did not differ (p=0.33). ICM patients had a left ventricular ejection fraction (LVEF) of 25±12%, 25/353 mismatched, and 46/353 matched defect segments. 82Rb washout was higher in hypoperfused vs normal segments (p82Rb washout correlated inversely with 82Rb uptake (r=-0.70; p82Rb washout does not distinguish between perfusion/metabolism patterns of hibernating myocardium and scar. Tissue integrity may be at least partially impaired in hibernation.

Original languageEnglish (US)
Pages (from-to)1507-1515
Number of pages9
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume38
Issue number8
DOIs
StatePublished - Aug 2011
Externally publishedYes

Fingerprint

Cardiomyopathies
Positron-Emission Tomography
Perfusion
Hibernation
Stroke Volume
Cicatrix
Myocardium
Potassium
Angiography

Keywords

  • Rb
  • FDG
  • Membrane integrity
  • Myocardial viability
  • PET/CT

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Washout of 82Rb as a marker of impaired tissue integrity, obtained by list-mode cardiac PET/CT : Relationship with perfusion/metabolism patterns of myocardial viability. / Chien, David T.; Bravo, Paco; Higuchi, Takahiro; Merrill, Jennifer; Bengel, Frank M.

In: European Journal of Nuclear Medicine and Molecular Imaging, Vol. 38, No. 8, 08.2011, p. 1507-1515.

Research output: Contribution to journalArticle

@article{de20c9654cae49ceb865cb605daab58b,
title = "Washout of 82Rb as a marker of impaired tissue integrity, obtained by list-mode cardiac PET/CT: Relationship with perfusion/metabolism patterns of myocardial viability",
abstract = "Purpose Myocardial washout of the potassium analogue 82Rb may indicate tissue impairment. Few studies have evaluated its usefulness for viability assessment, and controversial results were reported. We revisited this topic using list-mode positron emission tomography (PET)/CT. Methods A total of 22 patients with chronic ischemic cardiomyopathy (ICM) and 11 control subjects with normal CT coronary angiogram were studied. Rest 82Rb PET/CT studies were acquired in list mode and resampled to static, gated, and dynamic images. Using a 17-segment model, 82Rb washout was determined by monoexponential fitting of myocardial time-activity curves. In ICM patients, 18Ffluorodeoxyglucose (FDG) studies were obtained in the same session and segments were classified as normally perfused, mismatch, or matched defect. Results 82Rb washout was minimal and homogeneous in control subjects. Normally perfused segments of ICM did not differ (p=0.33). ICM patients had a left ventricular ejection fraction (LVEF) of 25±12{\%}, 25/353 mismatched, and 46/353 matched defect segments. 82Rb washout was higher in hypoperfused vs normal segments (p82Rb washout correlated inversely with 82Rb uptake (r=-0.70; p82Rb washout does not distinguish between perfusion/metabolism patterns of hibernating myocardium and scar. Tissue integrity may be at least partially impaired in hibernation.",
keywords = "Rb, FDG, Membrane integrity, Myocardial viability, PET/CT",
author = "Chien, {David T.} and Paco Bravo and Takahiro Higuchi and Jennifer Merrill and Bengel, {Frank M.}",
year = "2011",
month = "8",
doi = "10.1007/s00259-011-1820-2",
language = "English (US)",
volume = "38",
pages = "1507--1515",
journal = "European Journal of Nuclear Medicine and Molecular Imaging",
issn = "1619-7070",
publisher = "Springer Verlag",
number = "8",

}

TY - JOUR

T1 - Washout of 82Rb as a marker of impaired tissue integrity, obtained by list-mode cardiac PET/CT

T2 - Relationship with perfusion/metabolism patterns of myocardial viability

AU - Chien, David T.

AU - Bravo, Paco

AU - Higuchi, Takahiro

AU - Merrill, Jennifer

AU - Bengel, Frank M.

PY - 2011/8

Y1 - 2011/8

N2 - Purpose Myocardial washout of the potassium analogue 82Rb may indicate tissue impairment. Few studies have evaluated its usefulness for viability assessment, and controversial results were reported. We revisited this topic using list-mode positron emission tomography (PET)/CT. Methods A total of 22 patients with chronic ischemic cardiomyopathy (ICM) and 11 control subjects with normal CT coronary angiogram were studied. Rest 82Rb PET/CT studies were acquired in list mode and resampled to static, gated, and dynamic images. Using a 17-segment model, 82Rb washout was determined by monoexponential fitting of myocardial time-activity curves. In ICM patients, 18Ffluorodeoxyglucose (FDG) studies were obtained in the same session and segments were classified as normally perfused, mismatch, or matched defect. Results 82Rb washout was minimal and homogeneous in control subjects. Normally perfused segments of ICM did not differ (p=0.33). ICM patients had a left ventricular ejection fraction (LVEF) of 25±12%, 25/353 mismatched, and 46/353 matched defect segments. 82Rb washout was higher in hypoperfused vs normal segments (p82Rb washout correlated inversely with 82Rb uptake (r=-0.70; p82Rb washout does not distinguish between perfusion/metabolism patterns of hibernating myocardium and scar. Tissue integrity may be at least partially impaired in hibernation.

AB - Purpose Myocardial washout of the potassium analogue 82Rb may indicate tissue impairment. Few studies have evaluated its usefulness for viability assessment, and controversial results were reported. We revisited this topic using list-mode positron emission tomography (PET)/CT. Methods A total of 22 patients with chronic ischemic cardiomyopathy (ICM) and 11 control subjects with normal CT coronary angiogram were studied. Rest 82Rb PET/CT studies were acquired in list mode and resampled to static, gated, and dynamic images. Using a 17-segment model, 82Rb washout was determined by monoexponential fitting of myocardial time-activity curves. In ICM patients, 18Ffluorodeoxyglucose (FDG) studies were obtained in the same session and segments were classified as normally perfused, mismatch, or matched defect. Results 82Rb washout was minimal and homogeneous in control subjects. Normally perfused segments of ICM did not differ (p=0.33). ICM patients had a left ventricular ejection fraction (LVEF) of 25±12%, 25/353 mismatched, and 46/353 matched defect segments. 82Rb washout was higher in hypoperfused vs normal segments (p82Rb washout correlated inversely with 82Rb uptake (r=-0.70; p82Rb washout does not distinguish between perfusion/metabolism patterns of hibernating myocardium and scar. Tissue integrity may be at least partially impaired in hibernation.

KW - Rb

KW - FDG

KW - Membrane integrity

KW - Myocardial viability

KW - PET/CT

UR - http://www.scopus.com/inward/record.url?scp=80052561918&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052561918&partnerID=8YFLogxK

U2 - 10.1007/s00259-011-1820-2

DO - 10.1007/s00259-011-1820-2

M3 - Article

VL - 38

SP - 1507

EP - 1515

JO - European Journal of Nuclear Medicine and Molecular Imaging

JF - European Journal of Nuclear Medicine and Molecular Imaging

SN - 1619-7070

IS - 8

ER -