Circulation, Vol 87, 173-183, Copyright © 1993 by American Heart Association
P Herrero, J Markham, CJ Weinheimer, CJ Anderson, MJ Welch, MA Green and SR Bergmann
BACKGROUND. Noninvasive assessment of regional myocardial perfusion at rest
and after stress is important for the objective evaluation of the effects
of coronary artery disease and its response to therapy. Centers that do not
have cyclotrons rely on generator-produced radioisotopes for assessment of
regional myocardial perfusion with positron emission tomography (PET). The
aim of the present study was to develop and implement an approach to
quantify regional myocardial perfusion using copper(II) pyruvaldehyde
bis-(N4-thiosemicarbazone) (PTSM) labeled with the generator-produced,
positron-emitting radionuclide 62Cu (t1/2 = 9.7 minutes). METHODS AND
RESULTS. Regional perfusion was estimated from dynamic PET scans after
intravenous administration of 62Cu-PTSM in 21 studies in 13 intact dogs
evaluated over a wide range of myocardial flow values. In 15 interventions
in nine dogs, regional perfusion was also estimated with H2(15)O. Regional
perfusion with 62Cu-PTSM was estimated from dynamic blood and tissue
time-activity curves, along with the model parameter k1 (forward rate of
transport) and the PET parameter FBM (fraction of blood pool activity
observed in tissue), using a two-compartment kinetic model. Arterial blood
activity was corrected for red blood cell-associated 62Cu. In 44
comparisons, estimates of regional perfusion with 62Cu-PTSM correlated well
with estimates obtained with concomitantly administered radiolabeled
microspheres (y = 0.90x +/- 0.15, r = 0.95, p < 0.05) over a flow range
from 0.23 to 6.14 ml/g per minute. In five healthy human volunteers
evaluated at rest with H2(15)O and 62Cu-PTSM, regional perfusion estimated
with 62Cu-PTSM was not significantly different from that obtained with
H2(15)O (1.05 +/- 0.36 versus 0.96 +/- 0.28 ml/g per minute). 62Cu-PTSM
provided high-quality images of the heart. CONCLUSIONS. The results of this
study demonstrate that quantification of regional myocardial perfusion is
feasible using generator-produced 62Cu-PTSM. Since 62Cu-PTSM can be used to
estimate perfusion in the brain, kidney, and tumors as well as in the
heart, it is an attractive tracer for centers that rely on
generator-produced tracers for the evaluation of perfusion with PET.
ARTICLES
Quantification of regional myocardial perfusion with generator-produced 62Cu-PTSM and positron emission tomography
Cardiovascular Division, Washington University School of Medicine, St. Louis, Mo. 63110.
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