Myocardial

sensitivity, resolution Singapore PET and Cardiac Imaging Centre is the first
and higher diagnostic centre in Asia-Pacific region to perform Rb-82 myocardial
accuracy than SPECT. perfusion PET Imaging. Using a 64 slice PET/CT scanner,

Perfusion
The most commonly it is also possible to perform low dose Coronary CT
used PET tracers are angiography in the same sitting, providing “one stop
N13 Ammonia and anatomical and functional assessment” of coronary artery
Rb-82. Rb-82 is the disease. This provides improved diagnostic information
most widely used and risk stratification. Moreover, it is also possible to
radionuclide for assess- evaluate heart function during stress and rest. This
ment of myocardial information is not only useful for planning treatment
perfusion with PET. strategies, such as angioplasty or bypass surgery, but also
Rb-82 is a potassium analog that is a generator product for their follow-up.
with a physical half-life of 76s and kinetic properties similar
to those of Tl-201. PET tracers deliver relatively reduced
radiation dose to the patient than SPECT tracers.

PET also allows semi-quantitative assessment of

coronary blood flow, which is important in non-significant
obstructive CAD/pre-clinical CAD. Moreover, the gated
images at peak stress permit assessment of LVEF and
providing important prognostic information.

Cardiac PET imaging with C11 Acetate is the most

accurate method to quantitate myocardial oxygen
demand in various conditions. PET images with F18 FDG
permit assessment of myocardial viability in patient with
known CAD and impaired LV function.

Pte Ltd

290 Orchard Road #08-06 Paragon Medical

Singapore 238859

For more information please contact us at:

Co. Reg. No: 200711085N

Tel: 6836 1318 Fax: 6836 1381

Website: www.molecularimaging.com.sg

Figure 6: PET CTA Email: enquiry@molecularimaging.com.sg Pte Ltd

5 6
What is Myocardial Perfusion? Figure 1a Figure 3a
Rb-82 PET CTA
Heart disease, specifically coronary heart disease (CAD), Myocardial Moderate ischaemia
is the leading cause of death and disability among perfusion SPECT on the Rubidium-
both men and women. Reduction in blood flow due scan of a female 82 myocardial
patient revealing perfusion PET scan.
to narrowing of the arteries result in reduced oxygen
ischaemia in the This middle aged
and nutrient supply to the heart muscle. This can be man had exertional
anterior wall, while
manifested as chest pain (angina), shortness of breath chest pain, with
Rubidium-82 PET
and may lead to damage/scarring of the heart muscle non-conclusive
scan demonstrates exercise stress test.
(myocardial infarction) or sudden death. CAD is also a normal perfusion The correlative
cause of heart failure. with excellent CT angiography
image quality. images reveal
There are various imaging modalities that can be used for Rubidium-82 PET severe stenoses of
the diagnosis of CAD. However, currently CT Angiography has higher sensitivity proximal diagonal
and Myocardial Perfusion Imaging are two most commonly for detection of and LAD, consistent
significant CAD with with Rubidium
used non-invasive imaging methods. Coronary CT
excellent image findings. The
Angiography provides anatomical assessment, whereas, patient underwent
quality.
myocardial perfusion imaging detects areas of reduced subsequent PCI.
blood flow and heart function. Figure 1b Figure 3b
SPECT Rb-82 PET
In myocardial perfusion imaging, a small amount of
Figure 2a
radioactive material is injected intravenously and this Rb-82 PET
Figure 4:
tracer is taken up and retained in the heart tissue Mild obstruction of proximal LAD on coronary CTA, while
in proportion to regional blood supply. Usually, two Rubidium-82 PET is normal, with increased LVEF during
stress test.
scans are obtained after tracer injection, one at rest
and one in which the agent is injected during exercise
or medication-induced stress, such as with adenosine
Superior quality
dipyridamole, or dobutamine. Areas with reduced blood Rubidium PET
supply, either under resting condition or following stress images, compared
testing, indicates regions of scar or reversible perfusion with myocardial
alterations (ischemia), respectively. perfusion SPECT scan
in a patient
with dilated
cardiomyopathy.
Rubidium-82 PET Scan (Rb-82)

The most commonly available technique for myocardial

perfusion imaging has been Single-Photon Emission
Computed Tomography (SPECT). However, during recent
years Positron Emission Tomography (PET) has emerged Figure 2b
SPECT
as a preferred methodology. PET imaging has a higher
2 3 4