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Myocardial blood flow (MBF) and myocardial flow reserve (MFR) measured with PET have clinical value. SPECT cameras with solid-state detectors can obtain dynamic images for measurement of MBF and MFR. In this study, SPECT measurements of MBF made using 99m Tc-tetrofosmin were compared with PET in the same patients. Methods: Thirty-one patients underwent PET MBF rest-stress studies performed with 82 Rb or 13 N-ammonia within 1 mo of their SPECT study. Dynamic rest-stress measurements were made using a SPECT camera. Kinetic parameters were calculated using a 1-tissue-compartment model and converted to MBF and MFR. Processing with and without corrections for attenuation (+AC and -AC), patient body motion (+MC and -MC), and binding of the tracer to red blood cells (+BB and -BB) was evaluated. Results: Both +BB and +MC improved the accuracy and precision of global SPECT MBF compared with PET MBF, resulting in an average difference of 0.06 ± 0.37 mL/min/g. Global MBF and detection of abnormal MFR were not significantly improved with +AC. Global SPECT MFR with +MC and +BB had an area under the receiver-operating curve of 0.90 (+AC) to 0.95 (-AC) for detecting abnormal PET MFR less than 2.0. Regional analysis produced similar results with an area under the receiver-operating curve of 0.84 (+AC) to 0.87 (-AC). Conclusion: Solid-state SPECT provides global MBF and MFR measurements that differ from PET by 2% ± 32% (MBF) and 2% ± 28% (MFR).

Optimization of SPECT Measurement of Myocardial Blood Flow with Corrections for Attenuation, Motion, and Blood Binding Compared with PET