A1 Refereed original research article in a scientific journal
MYOCARDIAL BLOOD-FLOW - COMPARISON OF OXYGEN-15-WATER BOLUS INJECTION, SLOW INFUSION AND OXYGEN-15-CARBON DIOXIDE SLOW INHALATION
Authors: IIDA H, TAKAHASHI A, TAMURA Y, ONO Y, LAMMERTSMA AA
Publisher: SOC NUCLEAR MEDICINE INC
Publication year: 1995
Journal: Journal of Nuclear Medicine
Journal name in source: JOURNAL OF NUCLEAR MEDICINE
Journal acronym: J NUCL MED
Volume: 36
Issue: 1
First page : 78
Last page: 85
Number of pages: 8
ISSN: 0161-5505
Abstract
This study investigates the most appropriate protocol for measuring regional myocardial blood flow (MBF) using O-15-water in clinical applications. Methods: Regional MBF, perfusable tissue fraction (PTF) and arterial blood volume (V-a) were measured using O-15-water and dynamic PET on five healthy volunteers based on previously published models. Calculated values were compared for the following three tracer administration protocols: O-15-water bolus injection,O-15-water slow (2 min) infusion and O-15-carbon dioxide slow (2 min) inhalation. For the two slow administration protocols, the three parameters MBF, PTF and V, were computed by fitting the model equations to the myocardial regional time-activity curve. For the bolus injection of O-15-water, only two parameters, MBF and PTF, were fitted by using a fixed V,value obtained by a carbon dioxide blood volume scan. Results: All protocols provided consistent MBF values, and the calculated values were homogeneous throughout the whole myocardial segments for all subjects. PTF values were also homogeneous and consistent in the anterior and lateral wall regions, but were significantly greater in the septum (similar to 20%) when the slow O-15-carbon dioxide inhalation protocol was used. MBF and PTF values obtained from the bolus injection protocol showed the smallest intersubject and interregional variations. The simulation study also showed that the magnitude of error was smallest when the bolus injection protocol was employed. Conclusion: The data suggest that the O-15-water bolus injection protocol together with the two-parameter fitting procedure provides the most accurate results for MBF and PTF. However, it requires arterial cannulation and a separate carbon monoxide scan. For clinical studies, however, the O-15-water infusion protocol would be a good alternative, providing MBF and PTF results with an acceptable degree of accuracy and without the need for arterial cannulation.
This study investigates the most appropriate protocol for measuring regional myocardial blood flow (MBF) using O-15-water in clinical applications. Methods: Regional MBF, perfusable tissue fraction (PTF) and arterial blood volume (V-a) were measured using O-15-water and dynamic PET on five healthy volunteers based on previously published models. Calculated values were compared for the following three tracer administration protocols: O-15-water bolus injection,O-15-water slow (2 min) infusion and O-15-carbon dioxide slow (2 min) inhalation. For the two slow administration protocols, the three parameters MBF, PTF and V, were computed by fitting the model equations to the myocardial regional time-activity curve. For the bolus injection of O-15-water, only two parameters, MBF and PTF, were fitted by using a fixed V,value obtained by a carbon dioxide blood volume scan. Results: All protocols provided consistent MBF values, and the calculated values were homogeneous throughout the whole myocardial segments for all subjects. PTF values were also homogeneous and consistent in the anterior and lateral wall regions, but were significantly greater in the septum (similar to 20%) when the slow O-15-carbon dioxide inhalation protocol was used. MBF and PTF values obtained from the bolus injection protocol showed the smallest intersubject and interregional variations. The simulation study also showed that the magnitude of error was smallest when the bolus injection protocol was employed. Conclusion: The data suggest that the O-15-water bolus injection protocol together with the two-parameter fitting procedure provides the most accurate results for MBF and PTF. However, it requires arterial cannulation and a separate carbon monoxide scan. For clinical studies, however, the O-15-water infusion protocol would be a good alternative, providing MBF and PTF results with an acceptable degree of accuracy and without the need for arterial cannulation.
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