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Aim The study aim was to compare the kinetics of the potassium analogue, 82Rb, between spleen, liver and kidney. Methods Patients had myocardial stress/rest perfusion imaging using adenosine (n = 45) or regadenoson (n = 33) for stressing. Hepatic arterial (HAP), splenic (SP) and renal (RP) perfusions were measured from first‐pass and blood 82Rb clearances (Ki) from Gjedde–Patlak–Rutland graphical analysis of data between 1 and 2 min postinjection, using regions of interest over left ventricular cavity or abdominal aorta to monitor arterial concentration. Tissue 82Rb extraction efficiency (E) was calculated as [Ki/perfusion]*100. Tissue extracellular fluid volume (ECV) was derived from the GPR plot intercept. Results SP (24%) and RP (23%) increased after regadenoson but decreased (−41% and −19%) after adenosine. HAP increased after adenosine (91%) and regadenoson (68%). Resting E was high in kidney (69%) and low in spleen (26%). After adenosine, it increased to 91% in kidney and 49% in spleen. Assuming an arterial contribution of 25% to hepatic blood flow, resting E in liver was estimated as 23%. Relationships between Ki and perfusion in spleen and kidney were consistent with the Crone–Renkin equation (Ki = [1 − A.e‐B/perfusion]*perfusion), with respective values of A of 0.95 and 0.94 and B of 31 and 186 ml/min/100 ml. Splenic ECV decreased following adenosine from 62 to 39 ml/100 ml and showed a logarithmic correlation with SP. Conclusion Kidney, spleen and liver display contrasting tissue kinetics. E is high in kidney and low in spleen and liver. Spleen is erectile, collapsing when perfusion decreases.

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