13N-ammonia positron emission tomography-derived endocardial strain for the assessment of ischemia using feature-tracking in high-resolution cine imaging

Abstract

Background: Assessing endocardial strain using a single 13 N-ammonia positron emission tomography (PET) scan would be clinically useful, given the association between ischemia and myocardial deformation. However, no software has been developed for strain analysis using PET. We evaluated the clinical potential of feature tracking-derived strain values measured using PET, based on associations with the myocardial flow reserve (MFR). Methods and Results: This retrospective study included 95 coronary artery disease patients who underwent myocardial 13 N-ammonia PET. Semi-automatic measurements were made using a feature-tracking technique during myocardial cine imaging, and values were calculated using a 16-segment model. Adenosine-stressed global circumferential strain (CS) and global longitudinal strain (LS) values were compared with global MFR values. Stressed and resting global strain values were also compared. Global strain values were significantly lower in 39 patients with abnormal MFRs [<2.0] than in 56 patients with normal MFRsThe global CS values in the stressed state were significantly decreased than the resting state values in patients with abnormal MFRs. Conclusions:This study applied endocardial feature-tracking to 13 N-ammonia PET, and the results suggested that blood flow and myocardial motility could be clinically assessed in ischemic patients using a single PET scan.

13N-ammonia positron emission tomography-derived left-ventricular strain in patients after heart transplantation validated using cardiovascular magnetic resonance feature tracking as reference

“…A total of 15 patients who underwent 13 N-ammonia PET and CMR examinations after heart transplantation were retrospectively enrolled. PET and CMR scans were performed between April 2018 and March 2021.…”

“…Introduction 13 N-ammonia positron emission tomography (PET) allows for the calculation of the absolute values of myocardial blood flow and myocardial flow reserve (MFR) based on the ratio of myocardial blood flow during coronary artery vasodilation and at rest [1 5]. After heart transplantation, any rejection results in persistent coronary artery inflammation and vascular injury progression, known as cardiac allograft vasculopathy (CAV).…”

“…After heart transplantation, any rejection results in persistent coronary artery inflammation and vascular injury progression, known as cardiac allograft vasculopathy (CAV). Therefore, 13 N-ammonia PET is reportedly useful in detecting CAV, as it can evaluate both epicardial vessels and microvasculature [6]. According to the Registry of the International Society for Heart and Lung Transplantation, significant CAV leads to death between 1 and 3 years after transplantation [7].…”

“…-resolution cine imaging with 13 N-ammonia PET and feature-tracking (FT) technique [13]. This is a technological innovation with the potential to simultaneously evaluate myocardial blood flow and myocardial motility in a single PET examination.…”

“…This is a technological innovation with the potential to simultaneously evaluate myocardial blood flow and myocardial motility in a single PET examination. However, 13 N-ammonia PET strains have not been compared to strains derived from other conventional techniques, such as cardiovascular magnetic resonance (CMR) FT. In this study, we evaluated the regional examined the characteristics of regional wall motion in heart transplant patients and the potential for detecting CAV-related wall motion abnormalities using this newly defined technique.…”