Laboratory Investigation Quantification of Regional Myocardial Perfusion With Generator-Produced 62Cu-PTSM and Positron Emission Tomography

Background. Noninvasive assessment of regional myocardial perfusion at rest and after stress is important for the objective evaluation of the effects of coronary artery disease and its response to therapy. Centers that do not have cyclotrons rely on generator-produced radioisotopes for assessment of regional myocardial perfusion with positron emission tomography (PET). The aim of the present study was to develop and implement an approach to quantify regional myocardial perfusion using copper(II) pyruvaldehyde bis-(N4-thiosemicarbazone) (PTISM) labeled with the generator-produced, positron-emit-ting radionuclide 62Cu (t1,2=9.7 minutes). Methods and Results. Regional perfusion was estimated from dynamic PET scans after intravenous administration of 62Cu-PTSM in 21 studies in 13 intact dogs evaluated over a wide range of myocardial flow values. In 15 interventions in nine dogs, regional perfusion was also estimated with H215O. Regional perfusion with 62Cu-PISM was estimated from dynamic blood and tissue time-activity curves, along with the model parameter k, (forward rate of transport) and the PET parameter FBM (fraction of blood pool activity observed in tissue), using a two-compartment kinetic model. Arterial blood activity was corrected for red blood cell-associated '2Cu. In 44 comparisons, estimates of regional perfusion with 62Cu-PISM correlated well with estimates obtained with concomitantly administered radiolabeled microsphere