Positron Emission Tomography with Rubidium-82 in Myocardial Perfusion Imaging

Abstract

This review considers literature sources on myocardial perfusion studies using positron emission tomography with rubidium-82. The history of the development of the method, the protocols of the study, the dissymmetric data are analyzed, and comparisons are made with other positron emitters that are used in clinical practice and research to study myocardial blood supply. The use of PET/CT with rubidium-82 makes it possible to obtain valuable diagnostic information and it allows to measure myocardial blood directly and make a separate assessment of the coronary arteries function. Due to the fact that the production of rubidium-82 does not require an on-site cyclotron and a radiochemical laboratory, this method of imaging is more accessible than other positron emitters used for the same purpose. Also, the study is not associated with significant discomfort for the patient, since the full stress/rest imaging protocol requires less than half an hour. However, the use of rubidium-82 has a number of drawbacks, including the relatively low sharpness of the resulting image due to the high energy of the emitting positrons. Also there is a necessity for a mathematical correction of the roll-off phenomenon, which is a decrease in radiopharmaceutical extraction with an increase in myocardial blood flow. Due to the short half-life period, the provision of stress tests with ergometers is difficult. It needed to use pharmacological stress tests. In addition, usage of rubidium-82 is characterized by a high cost both due to the expensive production of the parent isotope, strontium-82, and the need for frequent replacement of generators – on average, 11 to 13 times a year.