Author(s) Renaud, J.M.; Wu, K.Yi; Gardner, K.; Aung, M.; Beanlands, R.S.B.; deKemp, R.A.
Journal J Nucl Cardiol
Date Published 2019 12

INTRODUCTION: Rubidium-82 (Rb) PET is used widely for myocardial perfusion imaging. The purpose of this study was to investigate if an additional saline-push following the Rb elution improves PET image quality.

METHODS: Rb PET scans were acquired with and without 26 mL saline-push in six patients as part of a clinical quality improvement program. Dynamic images were analyzed to measure the total activity delivered to the superior vena cava (SVC) and retained in the left ventricle (LV) myocardium. Tracer uptake images were used to measure blood background coefficient-of-variation (COV), myocardium-to-blood signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) to assess image quality.

RESULTS: Similar eluted activity was measured with/without the saline-push (830 vs 795 MBq; P = 0.24). The activity delivered to the heart and retained in the myocardium was consistently increased more than twofold (SVC: + 114% and LV: + 104%; P < 0.001) with the saline-push. Image quality was improved in all patients, with lower background noise (COV: - 19%), higher SNR (+ 24%) and CNR (+ 27%) (all P ≤ 0.01).

CONCLUSIONS: The saline-push used to flush Rb activity out of the infuser tubing, patient injection and intravenous access lines consistently increased the activity delivered to the heart by twofold. This technique is recommended to maximize image quality with Rb PET.

DOI 10.1007/s12350-018-1261-4
ISSN 1532-6551
Citation Renaud JM, Wu KY, Gardner K, Aung M, Beanlands RS, deKemp RA. Saline-push improves rubidium-82 PET image quality. J Nucl Cardiol. 2019;26(6):1869-1874.