Cardiac displacement during ¹³N-Ammonia myocardial perfusion PET/CT: comparison between adenosine and regadenoson induced stress

Abstract

Purpose: In this study, differences are investigated in cardiac displacement during adenosine stress versus regadenoson stress in ¹³N-Ammonia(¹³NH₃) MP PET/CT scans. Methods: A total of 61 MP PET/CTs were acquired using either adenosine (n=30) or regadenoson (n=31) as a stressor. For both groups, cardiac displacement during rest and stress was measured three-dimensionally, relative to either a fixed reference frame or the previous frame, in each 1-minute frame of a list-mode PET acquisition of 25 minutes. All stress scans were additionally evaluated for the presence of motion artifacts. Also, patient tolerability and occurrence of various side effects were compared between groups. Results: Significantly larger cardiac displacement during stress was detected in the adenosine group as compared to the regadenoson group, reflected by both maximal cardiac displacement (p=0.022) and mean cardiac displacement (p=0.001). The duration of the movement was typically shorter in the regadenoson group. Frames with cardiac displacement ≥5 mm were observed nearly twice as frequent when using adenosine instead of regadenoson. Conclusions: The displacement during regadenoson stress is of lower amplitude and lasts shorter, and may therefore contribute to the lower incidence of motion artifacts on regadenoson compared to adenosine induced stress PET/CT scans.