Segmental quantitative myocardial perfusion with PET for the detection of significant coronary artery disease in patients with stable angina

Berti, Valentina; Sciagrà, Roberto; Neglia, Danilo; Pietilä, Mikko; Scholte, Arthur J.; Nekolla, Stephan G.; Rouzet, François; Pupi, Alberto; Knuuti, Juhani

doi:10.1007/s00259-016-3362-0

Cited by 22 publications

(20 citation statements)

References 42 publications

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“…Results are also presented here for a subset of 6 subjects who agreed to receive DCE-MRI, prior to standard clinical invasive CAD assessments (maximum interval between PET and MR imaging was 7 days). All subjects were instructed to abstain from caffeine for 12h before PET and MR imaging, which acts as an adenosine receptor antagonist and can otherwise affect adenosine-induced stress imaging [11], [14]. Exclusion criteria for subject recruitment included history of severely compromised renal function (serum creatinine greater than 2.26 mg/dL or glomerular filtration rate ≤30 mL/min), pregnancy and contraindications to adenosine or MR imaging.…”

Section: Methodsmentioning

confidence: 99%

“…Dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) using gadolinium-based extracellular contrast agents, has also been used to derive absolute quantification of MBF. Quantitative MR studies have previously shown comparable diagnostic performance for the detection of obstructive CAD [10], [11], [12] compared to quantitative 15 O-water PET [13], [14], [15]. Various MR models have been used to describe the kinetics of gadolinium-based contrast agents through the myocardium.…”

Section: Introductionmentioning

confidence: 99%

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Multimodality Quantitative Assessments of Myocardial Perfusion Using Dynamic Contrast Enhanced Magnetic Resonance and ¹⁵O-Labeled Water Positron Emission Tomography Imaging

Papanastasiou

Williams

Dweck

et al. 2018

IEEE Trans. Radiat. Plasma Med. Sci.

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Kinetic modelling of myocardial perfusion imaging data allows the absolute quantification of myocardial blood flow (MBF) and can improve the diagnosis and clinical assessment of coronary artery disease (CAD). Positron emission tomography (PET) imaging is considered the reference standard technique for absolute quantification, whilst oxygen-15 (O)-water has been extensively implemented for MBF quantification. Dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) has also been used for MBF quantification and showed comparable diagnostic performance against (O)-water PET studies. We investigated for the first time the diagnostic performance of two different PET MBF analysis softwares PMOD and Carimas, for obstructive CAD detection against invasive clinical standard methods in 20 patients with known or suspected CAD. Fermi and distributed parameter modelling-derived MBF quantification from DCE-MRI was also compared against (O)-water PET, in a subgroup of 6 patients. The sensitivity and specificity for PMOD was significantly superior for obstructive CAD detection in both per vessel (0.83, 0.90) and per patient (0.86, 0.75) analysis, against Carimas (0.75, 0.65), (0.81, 0.70), respectively. We showed strong, significant correlations between MR and PET MBF quantifications (r=0.83-0.92). However, DP and PMOD analysis demonstrated comparable and higher haemodynamic differences between obstructive versus (no, minor or non)-obstructive CAD, against Fermi and Carimas analysis. Our MR method assessments against the optimum PET reference standard technique for perfusion analysis showed promising results in per segment level and can support further multi-modality assessments in larger patient cohorts. Further MR against PET assessments may help to determine their comparative diagnostic performance for obstructive CAD detection.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Multimodality Quantitative Assessments of Myocardial Perfusion Using Dynamic Contrast Enhanced Magnetic Resonance and ¹⁵O-Labeled Water Positron Emission Tomography Imaging

Papanastasiou

Williams

Dweck

et al. 2018

IEEE Trans. Radiat. Plasma Med. Sci.

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“…The most employed approach is based on the threshold formerly identified using receiver-operator characteristic analysis and recently validated in the PACIFIC study and classifies as abnormal the finding of at least two adjacent myocardial segments with hyperaemic flow of 2.30 mL/min/g or less [ 75 , 76 ]. A similar method had been effectively used in the quantitative PET sub-study of the EVINCI trial [ 77 ]. The standard evaluation of gated PET based on uptake images cannot be performed with [ 15 O]water, but LVEF can be determined using gated first-pass blood volume images covering the first minute after injection or gated parametric blood volume images [ 16 , 17 ].…”

Section: Interpretation Of Myocardial Perfusion Petmentioning

confidence: 99%

EANM procedural guidelines for PET/CT quantitative myocardial perfusion imaging

Sciagrà

Lubberink

Hyafil

et al. 2020

Eur J Nucl Med Mol Imaging

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The use of cardiac PET, and in particular of quantitative myocardial perfusion PET, has been growing during the last years, because scanners are becoming widely available and because several studies have convincingly demonstrated the advantages of this imaging approach. Therefore, there is a need of determining the procedural modalities for performing high-quality studies and obtaining from this demanding technique the most in terms of both measurement reliability and clinical data. Although the field is rapidly evolving, with progresses in hardware and software, and the near perspective of new tracers, the EANM Cardiovascular Committee found it reasonable and useful to expose in an updated text the state of the art of quantitative myocardial perfusion PET, in order to establish an effective use of this modality and to help implementing it on a wider basis. Together with the many steps necessary for the correct execution of quantitative measurements, the importance of a multiparametric approach and of a comprehensive and clinically useful report have been stressed.

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“…However, several recent studies have described the diagnostic accuracy of 15 O-water PET in comparison with coronary angiography. 49,[57][58][59] No late gadolinium enhancement (LGE) imaging was performed to assess the presence of myocardial scars, which might have influenced myocardial perfusion; however, the patients did not have any known myocardial infarctions and the left ventricular systolic function was normal in all subjects, why at least large infarctions were less likely. Different acquisition and post-processing methods inevitably result in differences in the myocardial segmentation between modalities.…”

Section: Study Limitationsmentioning

confidence: 99%

Evaluation of quantitative CMR perfusion imaging by comparison with simultaneous 15O-water-PET

Kero

Johansson

Engström³

et al. 2021

Journal of Nuclear Cardiology

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Background. We assessed the quantitative accuracy of cardiac perfusion measurements using dynamic contrast-enhanced MRI with simultaneous 15 O-water PET as reference with a fully integrated PET-MR scanner.Methods. 15 patients underwent simultaneous DCE MRI and 15 O-water PET scans at rest and adenosine-stress on an integrated PET-MR scanner. Correlation and agreement between MRI-and PET-based global and regional MBF values were assessed using correlation and Bland-Altman analysis.Results. Three subjects were excluded due to technical problems. Global mean (± SD) MBF values at rest and stress were 0.97 ± 0.27 and 3.19 ± 0.70 mL/g/min for MRI and 1.02 ± 0.28 and 3.13 ± 1.16 mL/g/min for PET (P = 0.66 and P = 0.81). The correlations between global and regional MRI-and PET-based MBF values were strong (r = 0.86 and r = 0.75). The biases were negligible for both global and regional MBF comparisons (0.01 and 0.00 mL/min/g for both), but the limits of agreement were wide for both global and regional MBF, with larger variability for high MBF-values.Conclusion. The correlation between simultaneous MBF measurements with DCE MRI and 15 O-water PET measured in an integrated PET-MRI was strong but the agreement was only moderate indicating that MRI-based quantitative MBF measurements is not ready for clinical introduction.

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Segmental quantitative myocardial perfusion with PET for the detection of significant coronary artery disease in patients with stable angina

Abstract: The assessment of absolute myocardial perfusion parameters measured at a segment level lead to reliable and accurate identification of patients with significant coronary stenosis at ICA and/or CCTA.

Cited by 22 publications

References 42 publications

Multimodality Quantitative Assessments of Myocardial Perfusion Using Dynamic Contrast Enhanced Magnetic Resonance and ¹⁵O-Labeled Water Positron Emission Tomography Imaging

Multimodality Quantitative Assessments of Myocardial Perfusion Using Dynamic Contrast Enhanced Magnetic Resonance and ¹⁵O-Labeled Water Positron Emission Tomography Imaging

EANM procedural guidelines for PET/CT quantitative myocardial perfusion imaging

Evaluation of quantitative CMR perfusion imaging by comparison with simultaneous 15O-water-PET

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Segmental quantitative myocardial perfusion with PET for the detection of significant coronary artery disease in patients with stable angina

Abstract: The assessment of absolute myocardial perfusion parameters measured at a segment level lead to reliable and accurate identification of patients with significant coronary stenosis at ICA and/or CCTA.

Cited by 22 publications

References 42 publications

Multimodality Quantitative Assessments of Myocardial Perfusion Using Dynamic Contrast Enhanced Magnetic Resonance and 15O-Labeled Water Positron Emission Tomography Imaging

Multimodality Quantitative Assessments of Myocardial Perfusion Using Dynamic Contrast Enhanced Magnetic Resonance and 15O-Labeled Water Positron Emission Tomography Imaging

EANM procedural guidelines for PET/CT quantitative myocardial perfusion imaging

Evaluation of quantitative CMR perfusion imaging by comparison with simultaneous 15O-water-PET

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Product

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Multimodality Quantitative Assessments of Myocardial Perfusion Using Dynamic Contrast Enhanced Magnetic Resonance and ¹⁵O-Labeled Water Positron Emission Tomography Imaging

Multimodality Quantitative Assessments of Myocardial Perfusion Using Dynamic Contrast Enhanced Magnetic Resonance and ¹⁵O-Labeled Water Positron Emission Tomography Imaging