Dataset Information

Optimization of the left ventricle ejection fraction estimate obtained during cardiac adenosine stress ⁸²Rubidium-PET scanning: impact of different reconstruction protocols.

ABSTRACT:

Background

Left ventricular ejection fraction (LVEF) estimation using adenosine stress myocardial perfusion imaging (MPI) can be challenging. The short half-life of adenosine and the guideline-recommended adenosine infusion stop during Rubidium-82 acquisition protocol may affect the accuracy and repeatability of the LVEF measures.

Methods

This study comprised 25 healthy volunteers (median age 23 years) who underwent repeat myocardial perfusion imaging (MPI) sessions employing Rubidium-82 PET/CT. A guideline-recommended reconstruction protocol was used for both rest and adenosine stress MPI (150-360 s post-radiotracer injection, standard_recon). For the stress MPI protocol, two additional reconstruction protocols were considered; one was employing 60 seconds data (150-210 seconds, short_fixed) and the other a dynamic frame window based on the bolus arrival of Rubidium-82 in the heart until 210 seconds (x-210 seconds, short_individual). We report rest and stress LVEF, the LVEF reserve, and the LVEF reserve repeatability.

Results

Differences in the LVEF assessments were observed between the guideline recommended and alternative reconstruction protocol (LVEF stress MPI: standard_recon = 68 ± 7%, short_fixed = 71 ± 7% (P = .08), short_individual = 72 ± 7% (P = .04)), and the LVEF reserve was reduced for the guideline-recommended protocol (standard_recon = 7.8 ± 3.5, short_fixed = 10.1 ± 3.7, short_individual = 10.5 ± 3.6, all P < .001). The best repeatability measures were obtained for the short_individual protocol (repeatability: standard_recon = 45.3%, short_fixed = 41.2%, short_individual = 31.7%).

Conclusion

We recommend using the short_individual reconstruction protocol for improved LVEF repeatability and reserve assessment. Alternatively, in centers with limited technical support we recommend the use of the short_fixed protocol.

SUBMITTER: Lassen ML

PROVIDER: S-EPMC9834342 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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Publications

Optimization of the left ventricle ejection fraction estimate obtained during cardiac adenosine stress <sup>82</sup>Rubidium-PET scanning: impact of different reconstruction protocols.

Lassen Martin Lyngby ML Wissenberg Mads M Byrne Christina C Kjaer Andreas A Hasbak Philip P

Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology 20220412 6

<h4>Background</h4>Left ventricular ejection fraction (LVEF) estimation using adenosine stress myocardial perfusion imaging (MPI) can be challenging. The short half-life of adenosine and the guideline-recommended adenosine infusion stop during Rubidium-82 acquisition protocol may affect the accuracy and repeatability of the LVEF measures.<h4>Methods</h4>This study comprised 25 healthy volunteers (median age 23 years) who underwent repeat myocardial perfusion imaging (MPI) sessions employing Rubi ...[more]

PMID: 35415824

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Project description:BackgroundChanges in renal blood flow (RBF) may play a pathophysiological role in hypertension and kidney disease. However, RBF determination in humans has proven difficult. We aimed to confirm the feasibility of RBF estimation based on positron emission tomography/computed tomography (PET/CT) and rubidium-82 (82Rb) using the abdominal aorta as input function in a 1-tissue compartment model.MethodsEighteen healthy subjects underwent two dynamic 82Rb PET/CT scans in two different fields of view (FOV). FOV-A included the left ventricular blood pool (LVBP), the abdominal aorta (AA) and the majority of the kidneys. FOV-B included AA and the kidneys in their entirety. In FOV-A, an input function was derived from LVBP and from AA, in FOV-B from AA. One-tissue compartmental modelling was performed using tissue time activity curves generated from volumes of interest (VOI) contouring the kidneys, where the renal clearance of 82Rb is represented by the K1 kinetic parameter. Total clearance for both kidneys was calculated by multiplying the K1 values with the volume of VOIs used for analysis. Intra-assay coefficients of variation and inter-observer variation were calculated.ResultsFor both kidneys, K1 values derived from AA did not differ significantly from values obtained from LVBP, neither were significant differences seen between AA in FOV-A and AA in FOV-B, nor between the right and left kidneys. For both kidneys, the intra-assay coefficients of variation were low (~ 5%) for both input functions. The measured K1 of 2.80 ml/min/cm3 translates to a total clearance for both kidneys of 766 ml/min/1.73 m2.ConclusionMeasurement of renal perfusion based on PET/CT and 82Rb using AA as input function in a 1-tissue compartment model is feasible in a single FOV. Based on previous studies showing 82Rb to be primarily present in plasma, the measured K1 clearance values are most likely representative of effective renal plasma flow (ERPF) rather than estimated RBF values, but as the accurate calculation of total clearance/flow is very much dependent on the analysed volume, a standardised definition for the employed renal volumes is needed to allow for proper comparison with standard ERPF and RBF reference methods.

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.

Dataset Information

Optimization of the left ventricle ejection fraction estimate obtained during cardiac adenosine stress ⁸²Rubidium-PET scanning: impact of different reconstruction protocols.

Background

Methods

Results

Conclusion

Publications

Optimization of the left ventricle ejection fraction estimate obtained during cardiac adenosine stress <sup>82</sup>Rubidium-PET scanning: impact of different reconstruction protocols.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Dataset Information

Optimization of the left ventricle ejection fraction estimate obtained during cardiac adenosine stress 82Rubidium-PET scanning: impact of different reconstruction protocols.

Background

Methods

Results

Conclusion

Publications

Optimization of the left ventricle ejection fraction estimate obtained during cardiac adenosine stress <sup>82</sup>Rubidium-PET scanning: impact of different reconstruction protocols.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Optimization of the left ventricle ejection fraction estimate obtained during cardiac adenosine stress ⁸²Rubidium-PET scanning: impact of different reconstruction protocols.