Tracer Kinetics & Absolute Blood Flow

The QPET algorithm for absolute blood flow quantification utilizes a previously-validated model for left ventricular segmentation and contouring developed by our center and applies it to dynamic data to quantify regional myocardial perfusion and absolute regional myocardial blood flow (MBF).

To obtain MBF, this algorithm uses LV myocardial regions of interest and automatically-assigned left and right ventricular blood pool regions which are used for the determination of the input bolus and for spillover correction in the myocardial region. Time-activity curves are generated from the acquired data, beginning with initiation of 82Rb infusion. MBF (in mL/min/g) is then calculated by fitting previously validated 82Rb, 2-compartment kinetic models (see references below) and correcting for the nonlinear dependence of the extraction fraction on flow for 82Rb.

Finally, the map of Coronary Flow Reserve (CFR) is derived by dividing the stress and rest flow polar maps. Regional distributions of MBF and CFR of the myocardium can be represented on a per-vessel basis or in a 17-segment AHA model.

PET Kinetics

  • Compartmental models
    deKemp RA, Declerck J, et al. Multisoftware Reproducibility Study of Stress and Rest Myocardial Blood Flow Assessed with 3D Dynamic PET/CT and a 1-Tissue-Compartment Model of 82Rb Kinetics. J Nucl Med 2013; 54(4):571–577   PDF (Source)
    Slomka PJ, Alexanderson E, et al. Comparison of Clinical Tools for Measurements of Regional Stress and Rest Myocardial Blood Flow Assessed with 13N-Ammonia PET/CT. J Nucl Med 2012; 53:171–181   PDF (Source)
    Yoshida K, Mullani N, et al. Coronary flow and flow reserve by PET simplified for clinical applications using rubidium-82 or nitrogen-13-ammonia. J Nucl Med 1996;37(10):1701-1712   PDF (Source)
    Coxson PG, Brennan KM, et al. Variability and reproducibility of rubidium-82 kinetic parameters in the myocardium of the anesthetized canine. J Nucl Med 1995;36(2):287-296   PDF (Source)

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