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Myocardial perfusion imaging using Rb-82 chloride

Case Study
Philips NM Clinical Science Philips Healthcare • USA

Courtesy of the University of Vermont.

Clinical history

This 56 year-old, 5'10," 139 kg male was referred to the University of Vermont for a myocardial perfusion scan. The technologist used the Vereos PET/CT to perform a myocardial perfusion imaging using Rb-82 chloride. A rest and stress phase was performed. Each phase used the administration of 30 mCi Rb-82 chloride. The data was acquired for seven minutes with ECG gating. Non-gated and gated myocardial images were generated using list mode reconstruction.

Scan parameters

PET
  • Rest/Stress
  • 30 mCi/1100 MBq Rb-82
  • 7 min acquisition
  • 4 mm voxel recon

CT
  • 120 kVp
  • 150 mAs

Images and interpretation

Diagnosis

No areas of decreased activity are seen to indicate reversible ischemia. Apical thinning is noted inferiorly.

Clinical significance

Rb-82 is a challenging radiopharmaceutical. The short half life dictates that a large amount is administered , and there is a limited amount of time to collect counts before all of the activity decays. In addition, the mean energy of the positron emitted from Rb-82 is much greater than F-18. The mean range is 2.6 mm, compared to 0.6 mm for F-18. This reduces the ability to precisely determine the origin of the Rb-82 atom at the time the positron is emitted. These images from Vereos still demonstrate visualization of the papillary muscle.


SPECT myocardial perfusion is limited with increasing patient size. In this case, the patient bmi is >40, well into the obese range. The appearance of the non-gated images and the gated images gives confidence that there are no significant perfusion defects.


* Results from case studies are not predictive of results in other cases. Results in other cases may vary.


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Feb 7, 2018

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Case Study
Vereos PET/CT
Cardiac, ECG-gated chest, gated chest, myocardial perfusion, obese patient, Rb-82 PET scan
 

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