Clinical implications of compromised 82 Rb PET data acquisition

Background We wished to document the prevalence and quantitative effects of compromised 82 Rb PET data acquisitions on myocardial flow reserve (MFR). Methods and Results Data were analyzed retrospectively for 246 rest and regadenoson-stress studies of 123 patients evaluated for known or suspected CAD. An automated injector delivered pre-determined activities of 82 Rb. Automated quality assurance algorithms identified technical problems for 7% (9/123) of patients. Stress data exhibited 2 instances of scanner saturation, 1 blood peak detection, 1 blood peak width, 1 gradual patient motion, and 2 abrupt patient motion problems. Rest data showed 1 instance of blood peak width and 2 abrupt patient motion problems. MFR was lower for patients with technical problems flagged by the quality assurance algorithms than those without technical problems (1.5 ± 0.5 versus 2.1 ± 0.7, P = 0.01), even though rest and stress ejection fraction, asynchrony and relative myocardial perfusion measures were similar for these two groups ( P > 0.05), suggesting that MFR accuracy was adversely affected by technical errors. Conclusion It is important to verify integrity of 82 Rb data to ensure MFR computation quality.