Clinical Presentation

A 57-year-old man with no known coronary artery disease is referred for a dobutamine myocardial perfusion PET/CT study to evaluate for atypical chest pain and dyspnea. His risk factors include hypertension and diabetes. He also has asthma and uses an albuterol inhaler daily. A resting ECG shows normal sinus rhythm and a right bundle branch block. He is also on aspirin at the time of testing.

Fig. 39.1

Technique

• The patient had nothing to eat within 4 hours of the study.

• After a scout CT acquisition (120 kVp, 10 mA) for patient positioning, a CT transmission scan (140 kVp, 30 mA, pitch of 1.35) was acquired for attenuation correction. Commercial software was used for coregistration of the transmission and emission images.

• Rest emission images were obtained after the intravenous administration of 55 mCi of ⁸²Rb at rest. Imaging began 90 seconds after completion of the radionuclide infusion for a total imaging time of 5 minutes.

• Gated images were acquired with 8-frame gating.

• Images were reconstructed with ordered subsets expectation maximization (OSEM; 2 iterations and 30 subsets), and a three-dimensional PET filter was used (Butterworth filter cutoff frequency of 10, order of 5).