Measurement of myocardial blood flow with oxygen-15 labelled water: Comparison of different administration protocols

Flemming Hermansen, Stuart D. Rosen, Farzin Fath-Ordoubadi, Jaspal S. Kooner, John C. Clark, Paolo G. Camici, Adriaan A. Lammertsma

Research output: Contribution to journalArticlepeer-review


Positron emission tomography (PET) in conjunction with C15O2, or H2 15O can be used to measure myocardial blood flow (MBF) and tissue fraction (TF), i.e. the fraction of the tissue mass in the volume of the region of interest. However, with C15O2 inhalation, the tissue fraction in the septum is overestimated. Bolus injection of H2 15O together with arterial cannulation gives very precise results but is invasive. The purpose of this study was to develop a method which circumvents these problems. A four-parameter model with parameters for MBE TF and spill-over fractions from both left and right ventricular cavities was developed. This method was compared with a three-parameter model (no right ventricular cavity spill-over) in both septal and non-septal regions of interest for three different administration protocols: bolus injection of H2 15O, infusion of H2 15O and inhalation of C15O2. It was found that MBF can be measured with intravenous administration of H2 15O without the requirement for arterial cannulation. The four-parameter protocol with bolus injection was stable in clinical studies. The four-parameter model proved essential for the septum, where it gave highly significantly better fits than did the three-parameter model (P <0.00003 in each of 15 subjects). Administration of H2 15O together with this four-parameter model also circumvented the problem of overestimation of TF in the septum seen with C15O2 inhalation. In addition, the radiation dose of H2 15O protocols is lower than that of C15O2 inhalation. Using a left atrial input curve instead of a left ventricular cavity input curve gave the same mean MBF and TF.

Original languageEnglish
Pages (from-to)751-759
Number of pages9
JournalEuropean Journal Of Nuclear Medicine
Issue number7
Publication statusPublished - 1998


  • Myocardial blood flow
  • Oxygen-15 labelled water
  • Positron emission tomography
  • Tracer kinetic modelling

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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