Dataset Information

Reducing motion-correction-induced variability in ⁸²rubidium myocardial blood-flow quantification.

ABSTRACT:

Background

Clinical use of myocardial blood flow (MBF) and flow reserve (MFR) is increasing. Motion correction is necessary to obtain accurate results but can introduce variability when performed manually. We sought to reduce that variability with an automated motion-correction algorithm.

Methods

A blinded randomized controlled trial of two technologists was performed on the motion correction of 100 dynamic ⁸²Rb patient studies comparing manual motion correction with manual review and adjustment of automated motion correction. Inter-rater variability between technologists for MBF and MFR was the primary outcome with comparison made by analysis of the limits of agreement. Processing time was the secondary outcome.

Results

Limits of agreements between the two technologists decreased significantly for both MBF and MFR, going from [- 0.22, 0.22] mL/min/g and [- 0.31, 0.36] to [- 0.12, 0.15] mL/min/g and [- 0.15, 0.18], respectively (both P < .002). In addition, the average time spent on motion correcting decreased by 1 min per study from 5:21 to 4:21 min (P = .001).

Conclusions

In this randomized controlled trial, the use of automated motion correction significantly decreased inter-user variability and reduced processing time.

SUBMITTER: Poitrasson-Riviere A

PROVIDER: S-EPMC7176539 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Publications

Reducing motion-correction-induced variability in <sup>82</sup>rubidium myocardial blood-flow quantification.

Poitrasson-Rivière Alexis A Moody Jonathan B JB Hagio Tomoe T Weinberg Richard L RL Corbett James R JR Murthy Venkatesh L VL Ficaro Edward P EP

Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology 20191023 4

<h4>Background</h4>Clinical use of myocardial blood flow (MBF) and flow reserve (MFR) is increasing. Motion correction is necessary to obtain accurate results but can introduce variability when performed manually. We sought to reduce that variability with an automated motion-correction algorithm.<h4>Methods</h4>A blinded randomized controlled trial of two technologists was performed on the motion correction of 100 dynamic <sup>82</sup>Rb patient studies comparing manual motion correction with ma ...[more]

PMID: 31646469

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Project description:BackgroundPatient motion can lead to misalignment of left ventricular (LV) volumes-of-interest (VOIs) and subsequently inaccurate quantification of myocardial blood flow (MBF) and flow reserve (MFR) from dynamic PET myocardial perfusion images. We aimed to develop an image-based 3D-automated motion-correction algorithm that corrects the full dynamic sequence for translational motion, especially in the early blood phase frames (~ first minute) where the injected tracer activity is transitioning from the blood pool to the myocardium and where conventional image registration algorithms have had limited success.MethodsWe studied 225 consecutive patients who underwent dynamic rest/stress rubidium-82 chloride (82Rb) PET imaging. Dynamic image series consisting of 30 frames were reconstructed with frame durations ranging from 5 to 80 seconds. An automated algorithm localized the RV and LV blood pools in space and time and then registered each frame to a tissue reference image volume using normalized gradient fields with a modification of a signed distance function. The computed shifts and their global and regional flow estimates were compared to those of reference shifts that were assessed by three physician readers.ResultsThe automated motion-correction shifts were within 5 mm of the manual motion-correction shifts across the entire sequence. The automated and manual motion-correction global MBF values had excellent linear agreement (R = 0.99, y = 0.97x + 0.06). Uncorrected flows outside of the limits of agreement with the manual motion-corrected flows were brought into agreement in 90% of the cases for global MBF and in 87% of the cases for global MFR. The limits of agreement for stress MBF were also reduced twofold globally and by fourfold in the RCA territory.ConclusionsAn image-based, automated motion-correction algorithm for dynamic PET across the entire dynamic sequence using normalized gradient fields matched the results of manual motion correction in reducing bias and variance in MBF and MFR, particularly in the RCA territory.

Project description:BackgroundCoronary microvascular dysfunction has been described in patients with autoimmune rheumatic disease (ARD). However, it is unknown whether positron emission tomography (PET)-derived myocardial flow reserve (MFR) can predict adverse events in this population.MethodsPatients with ARD without coronary artery disease who underwent dynamic rest-stress 82Rubidium PET were retrospectively studied and compared with patients without ARD matched for age, sex, and comorbidities. The association between MFR and a composite end point of mortality or myocardial infarction or heart failure admission was evaluated with time to event and Cox-regression analyses.ResultsIn 101 patients with ARD (88% female, age: 62±10 years), when compared with matched patients without ARD (n=101), global MFR was significantly reduced (median: 1.68 [interquartile range: 1.34-2.05] versus 1.86 [interquartile range: 1.58-2.28]) and reduced MFR (<1.5) was more frequent (40% versus 22%). MFR did not differ among subtypes of ARDs. In survival analysis, patients with ARD and low MFR (MFR<1.5) had decreased event-free survival for the combined end point, when compared with patients with and without ARD and normal MFR (MFR>1.5) and when compared with patients without ARD and low MFR, after adjustment for the nonlaboratory-based Framingham risk score, rest left ventricular ejection fraction, severe coronary calcification, and the presence of medium/large perfusion defects. In Cox-regression analysis, ARD diagnosis and reduced MFR were both independent predictors of adverse events along with congestive heart failure diagnosis and presence of medium/large stress perfusion defects on PET. Further analysis with inclusion of an interaction term between ARD and impaired MFR revealed no significant interaction effects between ARD and impaired MFR.ConclusionsIn our retrospective cohort analysis, patients with ARD had significantly reduced PET MFR compared with age-, sex-, and comorbidity-matched patients without ARD. Reduced PET MFR and ARD diagnosis were both independent predictors of adverse outcomes.

Project description:ObjectivesQuantification of myocardial blood flow (MBF) and stress/rest flow reserve is used increasingly to diagnose multi-vessel coronary artery disease and micro-vascular disease with PET imaging. However, variability in the measurements may limit physician confidence to direct revascularization therapies based on specific threshold values. This study evaluated the effects of rubidium-82 (82Rb) tracer injection profile using a constant-activity-rate (CA) vs a constant-flow-rate (CF) infusion to improve test-retest repeatability of MBF measurements.Method22 participants underwent single-session 82Rb dynamic PET imaging during rest and dipyridamole stress using one of 2 test-retest infusion protocols: CA-CA (n = 12) or CA-CF (n = 10). MBF was quantified using a single-tissue-compartment model (1TCM) and a simplified retention model (SRM). Non-parametric test-retest repeatability coefficients (RPCnp) were compared between groups. Myocardium-to-blood contrast and signal-to-noise ratios of the late uptake images (2 to 6 minutes) were also compared to evaluate standard myocardial perfusion image (MPI) quality.ResultsMBF values in the CA-CA group were more repeatable (smaller RPCnp) than the CA-CF group using the 1TCM at rest alone, rest and stress combined, and stress/rest reserve (21% vs 36%, 16% vs 19%, and 20% vs 27%, P < 0.05, respectively), and using the SRM at Rest and Stress alone, Rest and Stress combined, and stress/rest reserve (21% vs 38%, 15% vs 25%, 22% vs 38%, and 23% vs 49%, P < 0.05, respectively). In terms of image quality, myocardium-to-blood contrast and signal-to-noise ratios were not significantly different between groups.ConclusionsConstant-activity-rate 'square-wave' infusion of 82Rb produces more repeatable tracer injection profiles and decreases the test-retest variability of MBF measurements, when compared to a constant-flow-rate 'bolus' administration of 82Rb, especially with SRM, and without compromising standard MPI quality.

Dataset Information

Reducing motion-correction-induced variability in ⁸²rubidium myocardial blood-flow quantification.

Background

Methods

Results

Conclusions

Publications

Reducing motion-correction-induced variability in <sup>82</sup>rubidium myocardial blood-flow quantification.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Dataset Information

Reducing motion-correction-induced variability in 82rubidium myocardial blood-flow quantification.

Background

Methods

Results

Conclusions

Publications

Reducing motion-correction-induced variability in <sup>82</sup>rubidium myocardial blood-flow quantification.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Reducing motion-correction-induced variability in ⁸²rubidium myocardial blood-flow quantification.