Automatic generation of absolute myocardial blood flow images using [15O]H2O and a clinical PET/CT scanner

Abstract

PurposeParametric imaging of absolute myocardial blood flow (MBF) using [15O]H2O enables determination of MBF with high spatial resolution. The aim of this study was to develop a method for generating reproducible, high-quality and quantitative parametric MBF images with minimal user intervention.MethodsNineteen patients referred for evaluation of MBF underwent rest and adenosine stress [15O]H2O positron emission tomography (PET) scans. Ascending aorta and right ventricular (RV) cavity volumes of interest (VOIs) were used as input functions. Implementation of a basis function method (BFM) of the single-tissue model with an additional correction for RV spillover was used to generate parametric images. The average segmental MBF derived from parametric images was compared with MBF obtained using nonlinear least-squares regression (NLR) of VOI data. Four segmentation algorithms were evaluated for automatic extraction of input functions. Segmental MBF obtained using these input functions was compared with MBF obtained using manually defined input functions.ResultsThe average parametric MBF showed a high agreement with NLR-derived MBF [intraclass correlation coefficient (ICC) = 0.984]. For each segmentation algorithm there was at least one implementation that yielded high agreement (ICC > 0.9) with manually obtained input functions, although MBF calculated using each algorithm was at least 10% higher. Cluster analysis with six clusters yielded the highest agreement (ICC = 0.977), together with good segmentation reproducibility (coefficient of variation of MBF <5%).ConclusionParametric MBF images of diagnostic quality can be generated automatically using cluster analysis and a implementation of a BFM of the single-tissue model with additional RV spillover correction.Electronic supplementary materialThe online version of this article (doi:10.1007/s00259-011-1730-3) contains supplementary material, which is available to authorized users.

Myocardial Oxygen Consumption and Efficiency in Aortic Valve Stenosis Patients With and Without Heart Failure

“…Dynamic data sets were analyzed using the software package Cardiac VUer, as previously described 18. Image‐derived arterial input function was obtained automatically and corrected for metabolites 18, 19.…”

Use of a Single 11C-Meta-Hydroxyephedrine Scan for Assessing Flow–Innervation Mismatches in Patients with Ischemic Cardiomyopathy

“…0.75, V A or V RV . 0.60, or anatomic tissue fraction , 0.25, MBF, K 1 , and V T were set to zero to avoid spurious noise-induced high values outside the heart or in blood vessels as described previously (20,29). Finally, MBF T images were obtained by multiplying MBF images by PTF images.…”

“…Input functions were obtained using in-house-developed software, Cardiac VUer (20,21). For both 15 O-water and 11 C-HED, 1-cm-diameter regions of interest were placed over the ascending aorta in at least 5 transaxial image planes in the frame showing the first pass of the injected bolus.…”

“…For 15 O-water, parametric images were generated using a basis function implementation (20,26,27) of the single-tissue-compartment model (Eq. 1) with corrections for blood volume, spill-over (23), and PTF (28).…”

Quantitative myocardial blood flow imaging: not all flow is equal

“…Until recently, quantification of myocardial perfusion was primarily regarded as a research tool because it involved elaborate and time-consuming postprocessing procedures. Advances in PET systems have overcome these limitations and commercially available software packages currently generate quantitative MBF images in the order of minutes with high reproducibility [3]. As a consequence, absolute quantification of flow has ushered into the clinical arena.…”