Clinical Quantification of Myocardial Blood Flow Using PET: Joint Position Paper of the SNMMI Cardiovascular Council and the ASNC

Murthy, Venkatesh L.; Bateman, Timothy M.; Beanlands, Rob; Berman, Daniel S.; Borges‐Neto, Salvador; Chareonthaitawee, Panithaya; Cerqueira, Manuel D.; deKemp, Robert A.; DePuey, E. Gordon; Dilsizian, Vasken; Dorbala, Sharmila; Ficaro, Edward P.; Garcia, Ernest; Gewirtz, Henry; Heller, Gary V.; Lewin, Howard C.; Malhotra, Saurabh; Mann, April; Ruddy, Terrence D.; Schindler, Thomas H.; Schwartz, Ronald G.; Slomka, Piotr J.; Soman, Prem; Carli, Marcelo F. Di; Einstein, Andrew J.; Russell, Raymond R.; Corbett, James R.

doi:10.2967/jnumed.117.201368

Cited by 221 publications

(186 citation statements)

References 218 publications

(296 reference statements)

Supporting

Mentioning

165

Contrasting

Unclassified

Order By: Relevance

“…Compared with a clinical standard pulse sequence, the proposed pulse sequence produced overall visual score index that was not significantly different, while essentially doubling the myocardial coverage and increasing the spatial resolution. Compared with resting MBF values reported in literature (example 1: 0.61-1.10 mL/g/min averaging 363 subjects overall from 23 cardiac positron emission tomography studies 36 ; example 2: 0.95-1.03 mL/g/min based on a state-of-the-art dual-imaging and reconstruction method 20 ), the resting MBF values with KWIC filtering (TS = 20 ms for AIF, TS = 80 ms for wall enhancement) agreed better than without KWIC filtering (TS = 59 ms for AIF and wall enhancement). Our mean peak AIF of 9.2 mM following 0.10-mmol/kg administration of gadobutrol is comparable with peak AIF of 4.4 mM following 0.05-mmol/kg administration of gadobutrol reported by Kellman et al 20 This study addresses the challenges associated with achieving a good balance between competing factors: (1) increasing the myocardial coverage with high spatial resolution, (2) high image quality, and (3) accurate MBF quantification.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Accelerated, first‐pass cardiac perfusion pulse sequence with radial k‐space sampling, compressed sensing, and k‐space weighted image contrast reconstruction tailored for visual analysis and quantification of myocardial blood flow

Naresh

Haji‐Valizadeh

Aouad

et al. 2018

Magnetic Resonance in Med

View full text Add to dashboard Cite

Purpose To develop an accelerated cardiac perfusion pulse sequence and test whether it is capable of increasing spatial coverage, generating high‐quality images, and enabling quantification of myocardial blood flow (MBF). Methods We implemented an accelerated first‐pass cardiac perfusion pulse sequence by combining radial k‐space sampling, compressed sensing (CS), and k‐space weighted image contrast (KWIC) filtering. The proposed and clinical standard pulse sequences were evaluated in a randomized order in 13 patients at rest. For visual analysis, 3 readers graded the conspicuity of wall enhancement, artifact, and noise level on a 5‐point Likert scale (overall score index = sum of 3 individual scores). Resting MBF was calculated using a Fermi function model with and without KWIC filtering. Mean visual scores and MBF values were compared between sequences using appropriate statistical tests. Results The proposed pulse sequence produced greater spatial coverage (6–8 slices) with higher spatial resolution (1.6 × 1.6 × 8 mm3) and shorter readout duration (78 ms) compared to clinical standard (3–4 slices, 3 × 3 × 8 mm3, 128 ms, respectively). The overall image score index between accelerated (11.1 ± 1.3) and clinical standard (11.2 ± 1.3) was not significantly different (P = 0.64). Mean resting MBF values with KWIC filtering (0.9–1.2 mL/g/min across different slices) were significantly lower (P < 0.0001) than those without KWIC filtering (3.1–4.3 mL/g/min) and agreed better with values reported in literature. Conclusion An accelerated, first‐pass cardiac perfusion pulse sequence with radial k‐space sampling, CS, and KWIC filtering is capable of increasing spatial coverage, generating high‐quality images, and enabling quantification of MBF.

show abstract

Section: Discussionmentioning

confidence: 99%

“…The resting MBF values with KWIC filtering agree with resting MBF values reported in literature. 20,36 Nonetheless, future studies are warranted to validate the accuracy of MBF derived from our pulse sequence. Fourth, we did not evaluate the performance of our sequence during vasodilator stress.…”

Section: F I G U R E 4 Representative Cardiacmentioning

confidence: 99%

Accelerated, first‐pass cardiac perfusion pulse sequence with radial k‐space sampling, compressed sensing, and k‐space weighted image contrast reconstruction tailored for visual analysis and quantification of myocardial blood flow

Naresh

Haji‐Valizadeh

Aouad

et al. 2018

Magnetic Resonance in Med

View full text Add to dashboard Cite

show abstract

“…The end-point of MFR by N-13 ammonia PET is well validated in the nuclear cardiology literature. 5 However, the study has weaknesses that limit our ability to interpret the results. The first is its overall design and execution.…”

mentioning

confidence: 99%

Meditation in cardiac rehabilitation: Should we be thinking about it?

Gibbons

Thomas

2021

Journal of Nuclear Cardiology

View full text Add to dashboard Cite

“…A number of tracer kinetic models have been validated indicating that this technology provides robust qualitative, semi-quantitative and quantitative information in many settings of clinical cardiology. 23 The kinetics measured simultaneously for Gd-DTPA as shown in Figure 1 indicates that the basic behavior of 13 N-ammonia and Gd-chelates are quite different because gadolinium chelates never enter a myocardial cell but are restricted to the plasma volume and the interstitial space. Therefore, the imaging signal is very transient and requires challenging modelling with relatively low signal to noise ratio to extract quantitative information.…”

mentioning

confidence: 99%

What did we learn from PET/MR?

Schwaiger

Nekolla

2020

Journal of Nuclear Cardiology

View full text Add to dashboard Cite

In this JNC issue, Dr. Autio and his colleagues introduce 68 Ga-DOTA chelate as new tracer for the delineation of myocardial perfusion as well as extracellular space in a rodent infarct model. This application has most likely been triggered by the fact that gadolinium chelates are widely being used as contrast agent in magnetic resonance imaging (MRI). In cardiac MRI (CMRI), the use of Gd-chelates represents an established technology for the work-up of patients with coronary artery disease. Quite interestingly, this class of MR contrast agents was modeled in the 1980s after a tracer principle in nuclear medicine-99m Tc-DTPA. 1 The advantages of MRI in terms of high spatial resolution and lack of ionizing radiation have supported the clinical application of Gd-chelates for the imaging of myocardial perfusion, the delineation of myocardial scar as well as-in more general terms-for the detection of alterations in extracellular volume. 2-4 However, there have been questions about the possible toxicity of these contrast agents as gadolinium deposits were found in brain tissue. 5 Nevertheless, the technology remains a standard procedure in many cardiovascular imaging centers. Based on this positive experience, it is not surprising that using 68 Ga-labelled chelates in combination with dynamic PET acquisition allows a replication of data established in the MR community. The sophisticated first-pass analysis established at the laboratory of the Turku investigators, mainly using 15 Owater as the PET tracer, allows an almost automatic quantitative analysis yielding absolute measurements of myocardial perfusion as shown in many publications. 6 The group at the University of Turku has already demonstrated that PET 15 O-water studies in the normal flow range correlate with the perfusion results obtained after the intravenous bolus injection of 68 Ga-DOTA. 7 The paper by Dr. Autio et al raises an important question: What are the relative advantages of PET vs MR imaging for extracting biological information such as myocardial perfusion, extracellular space and myocardial infarct extension? For the clinical work-up of patients with suspected coronary artery disease the need for an accurate and robust assessment of myocardial perfusion and coronary flow reserve has been recognized for decades. 8 Currently, the most commonly used PET tracer is rubidium-82 ( 82 Rb) because it is generator-used and allows rapid evaluation of rest and stress perfusion due to its short physical half-life of 76 seconds. 9 In the scientific community, 13 N-ammonia has gained acceptance since it has a high myocardial extraction coupled with a suitable physical half-life of 10 minutes to provide excellent image quality due to the high-tracer retention. 10 The drawback of 13 N-ammonia is the need of an onsite cyclotron, which limits the use to primarily academic institutions. The same applies to 15 O-water, which represents a freely diffusible used for cerebral and myocardial perfusion measurements.Many publications have indicated that with both 15 O-water...

show abstract

Clinical Quantification of Myocardial Blood Flow Using PET: Joint Position Paper of the SNMMI Cardiovascular Council and the ASNC

Cited by 221 publications

References 218 publications

Accelerated, first‐pass cardiac perfusion pulse sequence with radial k‐space sampling, compressed sensing, and k‐space weighted image contrast reconstruction tailored for visual analysis and quantification of myocardial blood flow

Accelerated, first‐pass cardiac perfusion pulse sequence with radial k‐space sampling, compressed sensing, and k‐space weighted image contrast reconstruction tailored for visual analysis and quantification of myocardial blood flow

Meditation in cardiac rehabilitation: Should we be thinking about it?

What did we learn from PET/MR?

Contact Info

Product

Resources

About