Improved myocardial blood flow estimation with residual activity correction and motion correction in 18 F-flurpiridaz PET myocardial perfusion imaging 

Otaki, Yuka; Kriekinge, Serge D. Van; Wei, Chih-Chun; Kavanagh, Paul; Singh, Ananya; Parekh, Tejas; Carli, Marcelo Di; Maddahi, Jamshid; Sitek, Arkadiusz; Buckley, Christopher; Berman, Daniel S.; Slomka, Piotr J.

We sought to evaluate the diagnostic performance for coronary artery disease (CAD) of myocardial blood flow (MBF) quantification with 18F-flurpiridaz PET using motion correction (MC) and residual activity correction (RAC).

In total, 231 patients undergoing same-day pharmacologic rest and stress 18F-flurpiridaz PET from Phase III Flurpiridaz trial (NCT01347710) were studied. Frame-by-frame MC was performed and RAC was accomplished by subtracting the rest residual counts from the dynamic stress polar maps. MBF and myocardial flow reserve (MFR) were derived with a two-compartment early kinetic model for the entire left ventricle (global), each coronary territory, and 17-segment. Global and minimal values of three territorial (minimal vessel) and segmental estimation (minimal segment) of stress MBF and MFR were evaluated in the prediction of CAD. MBF and MFR were evaluated with and without MC and RAC (1: no MC/no RAC, 2: no MC/RAC, 3: MC/RAC).