The clinical utility of assessing myocardial blood flow using positron emission tomography

Ziadi, Maria C.; Beanlands, Rob

doi:10.1007/s12350-010-9258-7

Cited by 38 publications

(20 citation statements)

References 49 publications

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“…Absol ute quantification of myocardial blood flow (MBF) at stress and rest with dynamic PET imaging is an important tool for clinicians and provides information complementary to relative myocardial perfusion imaging (1)(2)(3). With standard list-mode acquisition and fast image reconstruction, dynamic, gated, and standard static perfusion images can be obtained with a single injection of the radiopharmaceutical and without additional imaging time.…”

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confidence: 99%

Multisoftware Reproducibility Study of Stress and Rest Myocardial Blood Flow Assessed with 3D Dynamic PET/CT and a 1-Tissue-Compartment Model of ⁸²Rb Kinetics

et al. 2013

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Routine quantification of myocardial blood flow (MBF) requires robust and reproducible processing of dynamic image series. The goal of this study was to evaluate the reproducibility of 3 highly automated software programs commonly used for absolute MBF and flow reserve (stress/rest MBF) assessment with 82 Rb PET imaging. Methods: Dynamic rest and stress 82 Rb PET scans were selected in 30 sequential patient studies performed at 3 separate institutions using 3 different 3-dimensional PET/CT scanners. All 90 scans were processed with 3 different MBF quantifi-cation programs, using the same 1-tissue-compartment model. Global (left ventricle) and regional (left anterior descending, left circumflex, and right coronary arteries) MBF and flow reserve were compared among programs using correlation and Bland-Altman analyses. Results: All scans were processed successfully by the 3 programs, with minimal operator interactions. Global and regional correlations of MBF and flow reserve all had an R 2 of at least 0.92. There was no significant difference in flow values at rest (P 5 0.68), stress (P 5 0.14), or reserve (P 5 0.35) among the 3 programs. Bland-Altman coefficients of reproducibility (1.96 · SD) averaged 0.26 for MBF and 0.29 for flow reserve differences among programs. Average pairwise differences were all less than 10%, indicating good reproducibility for MBF quantification. Global and regional SD from the line of perfect agreement averaged 0.15 and 0.17 mL/min/g, respectively, for MBF, compared with 0.22 and 0.26, respectively, for flow reserve. Conclusion: The 1-tissue-compartment model of 82 Rb tracer kinetics is a reproducible method for quantification of MBF and flow reserve with 3-dimensional PET/CT imaging. Absol ute quantification of myocardial blood flow (MBF) at stress and rest with dynamic PET imaging is an important tool for clinicians and provides information complementary to relative myocardial perfusion imaging (1-3). With standard list-mode acquisition and fast image reconstruction , dynamic, gated, and standard static perfusion images can be obtained with a single injection of the radiopharmaceutical and without additional imaging time. Automated image analysis tools are required for reliable and robust clinical use of dynamic data for MBF quantification (4). The performance of several such software programs for MBF quan-tification has been reported recently (5-9), each of which uses different tracers and methods of segmenting and sampling the left ventricular myocardium and blood-pool activity to obtain input curves. Although each of these tools greatly simplifies MBF quantification, uses the same tracer kinetic model for 82 Rb-rubidium (10), and has been validated individually , the effect of different model implementations has not been characterized. Previous studies have compared different tracer kinetic models and implementations for 13 N-ammonia (11,12) but not for 82 Rb-rubidium and in particular not for 3-dimensional (3D)-mode PET, which is the current standard technology. We aimed to comp...

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confidence: 99%

Multisoftware Reproducibility Study of Stress and Rest Myocardial Blood Flow Assessed with 3D Dynamic PET/CT and a 1-Tissue-Compartment Model of ⁸²Rb Kinetics

et al. 2013

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“…[1][2][3][4][5][6] Assessing CFR provides significantly greater separation of low-and high-risk subsets of patients compared with conventional single photon emission tomography or PET, imaging in which only relative tracer uptake is evaluated after exercise or pharmacological stress. Certainly, the traditional semiquantitative techniques used for many years for conventional single photon emission tomography and PET MPI have provided valuable diagnostic and prognostic information, particularly when extensive focal defects are identified on poststress images, which normalize on resting studies.…”

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confidence: 99%

Enhanced Risk Stratification With Noninvasive Measurement of Coronary Flow Reserve Using Positron Emission Tomography

Beller

2012

Circulation

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“…But we chose the LAD territory because it was demonstrated to be LAD-dominant in several studies [2,26]. Hemodynamic change can still be a problem because multi-vessel disease induces coronary steal phenomenon via collateral circulation [27], which was not definitely observed in our patients. However, the exact effects of hemodynamic change in multi-vessel disease on findings of MPI are yet to be completely known and should be studied in the future.…”

Section: Discussionmentioning

confidence: 93%

Myocardial Blood Flow and Flow Reserve in Proximal and Mid-to-Distal Lesions of Left Anterior Descending Artery Measured By N-13 Ammonia PET/CT

Cho

Kim

Cho

et al. 2013

Nucl Med Mol Imaging

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Purpose The purpose of this study is to compare the myocardial blood flow (MBF) and flow reserve (MFR) between proximal and mid-to-distal lesions of the left anterior descending artery (pLAD and mdLAD, respectively) using N-13 ammonia positron emission tomography/computed tomography (PET/CT). Methods Subjects were 11 patients (six men and five women, mean age 64.5 years) with known coronary artery disease (CAD) involving LAD studied by N-13 ammonia PET/CT. They were divided into two groups by the location of stenotic lesions, i.e. pLAD versus mdLAD. Global and regional MBF and MFR were measured and compared. Characteristics of perfusion defects including the number of involved segments, basal area involvement, location, size, and shape were also compared between the two groups. Results The regional MFR in mid-anterior segment was significantly lower in pLAD group (1.80±0.35 vs 2.76±1.13 for pLAD and mdLAD groups, respectively, p=0.034), while global MFR was not different (2.10±1.10 vs 2.34±0.84).Both stress and rest MBF in LAD territories were not different in both groups. The size of the perfusion defects were significantly larger in pLAD group (44.0±11.5 % vs 21.1±15.8 %, p=0.041). Other characteristics such as location, basal area involvement, and shape were not significantly different between two groups. Conclusions The proximal lesion makes lower MFR in the mid-anterior segment and larger perfusion defect in the LAD territory but comparable MBF compared with mdLAD lesion.

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The clinical utility of assessing myocardial blood flow using positron emission tomography

Cited by 38 publications

References 49 publications

Multisoftware Reproducibility Study of Stress and Rest Myocardial Blood Flow Assessed with 3D Dynamic PET/CT and a 1-Tissue-Compartment Model of ⁸²Rb Kinetics

Multisoftware Reproducibility Study of Stress and Rest Myocardial Blood Flow Assessed with 3D Dynamic PET/CT and a 1-Tissue-Compartment Model of ⁸²Rb Kinetics

Enhanced Risk Stratification With Noninvasive Measurement of Coronary Flow Reserve Using Positron Emission Tomography

Myocardial Blood Flow and Flow Reserve in Proximal and Mid-to-Distal Lesions of Left Anterior Descending Artery Measured By N-13 Ammonia PET/CT

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The clinical utility of assessing myocardial blood flow using positron emission tomography

Cited by 38 publications

References 49 publications

Multisoftware Reproducibility Study of Stress and Rest Myocardial Blood Flow Assessed with 3D Dynamic PET/CT and a 1-Tissue-Compartment Model of 82Rb Kinetics

Multisoftware Reproducibility Study of Stress and Rest Myocardial Blood Flow Assessed with 3D Dynamic PET/CT and a 1-Tissue-Compartment Model of 82Rb Kinetics

Enhanced Risk Stratification With Noninvasive Measurement of Coronary Flow Reserve Using Positron Emission Tomography

Myocardial Blood Flow and Flow Reserve in Proximal and Mid-to-Distal Lesions of Left Anterior Descending Artery Measured By N-13 Ammonia PET/CT

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Multisoftware Reproducibility Study of Stress and Rest Myocardial Blood Flow Assessed with 3D Dynamic PET/CT and a 1-Tissue-Compartment Model of ⁸²Rb Kinetics

Multisoftware Reproducibility Study of Stress and Rest Myocardial Blood Flow Assessed with 3D Dynamic PET/CT and a 1-Tissue-Compartment Model of ⁸²Rb Kinetics