Cardiac Displacement During 13N-Ammonia Myocardial Perfusion PET/CT: Comparison Between Adenosine- and Regadenoson-Induced Stress

J Nucl Med Technol. 2018 Jun;46(2):114-122. doi: 10.2967/jnmt.117.199463. Epub 2017 Dec 22.

Abstract

This study investigated differences in cardiac displacement during adenosine stress versus regadenoson stress in 13N-ammonia (13NH3) MP PET/CT scans. Methods: In total, 61 myocardial perfusion PET/CT scans 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 3-dimensionally, relative to either a fixed reference frame or the previous frame, in each 1-min frame of a list-mode PET acquisition of 25 min. All stress scans were additionally evaluated for the presence of motion artifacts. Also, the tolerability of the agents and the occurrence of side effects were compared between groups. Results: Significantly larger cardiac displacement during stress was detected in the adenosine group than in 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 of at least 5 mm were observed nearly twice as frequently when adenosine was used instead of regadenoson. Conclusion: The displacement during regadenoson stress is of lower amplitude and shorter duration than that during adenosine stress and may therefore contribute to a lower incidence of motion artifacts on PET/CT scans.

Keywords: adenosine; ammonia; motion artifacts; myocardial perfusion PET/CT; pharmacologic stress; regadenoson.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Adenosine / adverse effects
  • Adenosine / pharmacology*
  • Adult
  • Ammonia*
  • Artifacts
  • Female
  • Heart / diagnostic imaging*
  • Heart / drug effects
  • Heart / physiology
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Myocardial Perfusion Imaging / methods*
  • Nitrogen Radioisotopes
  • Positron Emission Tomography Computed Tomography / methods*
  • Purines / adverse effects
  • Purines / pharmacology*
  • Pyrazoles / adverse effects
  • Pyrazoles / pharmacology*
  • Safety
  • Stress, Physiological / drug effects*

Substances

  • Nitrogen Radioisotopes
  • Nitrogen-13
  • Purines
  • Pyrazoles
  • regadenoson
  • Ammonia
  • Adenosine