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Cantoni V, Green R, D'Antonio A, Cuocolo A. Dynamic CZT-SPECT in coronary artery disease: Where are we now? J Nucl Cardiol 2022; 29:1698-1701. [PMID: 34350552 DOI: 10.1007/s12350-021-02752-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 07/09/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Valeria Cantoni
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy.
| | - Roberta Green
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Adriana D'Antonio
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
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Kudomi N, Kalliokoski KK, Oikonen VJ, Han C, Kemppainen J, Sipilä HT, Knuuti J, Heinonen IHA. Myocardial Blood Flow and Metabolic Rate of Oxygen Measurement in the Right and Left Ventricles at Rest and During Exercise Using 15O-Labeled Compounds and PET. Front Physiol 2019; 10:741. [PMID: 31275160 PMCID: PMC6593089 DOI: 10.3389/fphys.2019.00741] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 05/28/2019] [Indexed: 11/13/2022] Open
Abstract
Aims: Simultaneous measurement of right (RV) and left ventricle (LV) myocardial blood flow (MBF), oxygen extraction fraction (OEF), and oxygen consumption (MVO2) non-invasively in humans would provide new possibilities to understand cardiac physiology and different patho-physiological states. Methods: We developed and tested an optimized novel method to measure MBF, OEF, and MVO2 simultaneously both in the RV and LV free wall (FW) using positron emission tomography in healthy young men at rest and during supine bicycle exercise. Results: Resting MBF was not significantly different between the three myocardial regions. Exercise increased MBF in the LVFW and septum, but MBF was lower in the RV compared to septum and LVFW during exercise. Resting OEF was similar between the three different myocardial regions (~70%) and increased in response to exercise similarly in all regions. MVO2 increased approximately two to three times from rest to exercise in all myocardial regions, but was significantly lower in the RV during exercise as compared to septum LVFW. Conclusion: MBF, OEF, and MVO2 can be assessed simultaneously in the RV and LV myocardia at rest and during exercise. Although there are no major differences in the MBF and OEF between LV and RV myocardial regions in the resting myocardium, MVO2 per gram of myocardium appears to be lower the RV in the exercising healthy human heart due to lower mean blood flow. The presented method may provide valuable insights for the assessment of MBF, OEF and MVO2 in hearts in different pathophysiological states.
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Affiliation(s)
- Nobuyuki Kudomi
- Turku PET Centre, University of Turku, Turku, Finland.,Department of Medical Physics, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | | | | | - Chunlei Han
- Turku PET Centre, University of Turku, Turku, Finland
| | - Jukka Kemppainen
- Turku PET Centre, University of Turku, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | | | - Juhani Knuuti
- Turku PET Centre, University of Turku, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Ilkka H A Heinonen
- Turku PET Centre, University of Turku, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Turku, Finland.,Rydberg Laboratory of Applied Sciences, University of Halmstad, Halmstad, Sweden
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Agostini D, Roule V, Nganoa C, Roth N, Baavour R, Parienti JJ, Beygui F, Manrique A. First validation of myocardial flow reserve assessed by dynamic 99mTc-sestamibi CZT-SPECT camera: head to head comparison with 15O-water PET and fractional flow reserve in patients with suspected coronary artery disease. The WATERDAY study. Eur J Nucl Med Mol Imaging 2018; 45:1079-1090. [PMID: 29497801 PMCID: PMC5953996 DOI: 10.1007/s00259-018-3958-7] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 01/22/2018] [Indexed: 12/23/2022]
Abstract
PURPOSE We assessed the feasibility of myocardial blood flow (MBF) and flow reserve (MFR) estimation using dynamic SPECT with a novel CZT camera in patients with stable CAD, in comparison with 15O-water PET and fractional flow reserve (FFR). METHODS Thirty patients were prospectively included and underwent FFR measurements in the main coronary arteries (LAD, LCx, RCA). A stenosis ≥50% was considered obstructive and a FFR abnormal if ≤0.8. All patients underwent a dynamic rest/stress 99mTc-sestamibi CZT-SPECT and 15O-water PET for MBF and MFR calculation. Net retention kinetic modeling was applied to SPECT data to estimate global uptake values, and MBF was derived using Leppo correction. Ischemia by PET and CZT-SPECT was considered present if MFR was lower than 2 and 2.1, respectively. RESULTS CZT-SPECT yielded higher stress and rest MBF compared to PET for global and LAD and LCx territories, but not in RCA territory. MFR was similar in global and each vessel territory for both modalities. The sensitivity, specificity, accuracy, positive and negative predictive value of CZT-SPECT were, respectively, 83.3, 95.8, 93.3, 100 and 85.7% for the detection of ischemia and 58.3, 84.6, 81.1, 36.8 and 93% for the detection of hemodynamically significant stenosis (FFR ≤ 0.8). CONCLUSIONS Dynamic 99mTc-sestamibi CZT-SPECT was technically feasible and provided similar MFR compared to 15O-water PET and high diagnostic value for detecting impaired MFR and abnormal FFR in patients with stable CAD.
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Affiliation(s)
- Denis Agostini
- Department of Nuclear Medicine, CHU Caen, CHU Cote de Nacre, Caen, France.
- Normandy University, EA 4650, Caen, France.
| | | | - Catherine Nganoa
- Department of Nuclear Medicine, CHU Caen, CHU Cote de Nacre, Caen, France
| | | | | | | | - Farzin Beygui
- Normandy University, EA 4650, Caen, France
- Department of Cardiology, CHU Caen, Caen, France
| | - Alain Manrique
- Department of Nuclear Medicine, CHU Caen, CHU Cote de Nacre, Caen, France
- Normandy University, EA 4650, Caen, France
- Cyceron PET Center, Caen, France
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4
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Assessment of coronary flow reserve using a combination of planar first-pass angiography and myocardial SPECT: Comparison with myocardial (15)O-water PET. Int J Cardiol 2016; 222:209-212. [PMID: 27497096 DOI: 10.1016/j.ijcard.2016.07.183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 07/28/2016] [Indexed: 11/20/2022]
Abstract
UNLABELLED Coronary flow reserve (CFR), defined as the ratio of maximum coronary flow increase from baseline resting blood flow, is one of the most sensitive parameters to detect early signs of coronary arteriosclerosis at the microvascular level. Myocardial perfusion PET is a well-established technology for CFR measurement, however, availability is still limited. The aim of this study is to introduce and validate myocardial flow reserve measurement by myocardial perfusion SPECT. METHODS Myocardial perfusion SPECT at rest and ATP stress (0.16mg/Kg/min) was performed in 10 patients with known coronary artery disease. Immediately after the injection of Tc-99m sestamibi (MIBI), left ventricular (LV) dynamic planar angiographic data were obtained for 90s. Coronary flow reserve index as measured by MIBI SPECT (CFRMIBI) was calculated as follows: CFRMIBI=CmsSbmb/CmbSbms, where subscripts b, s, Cm, and Sbm indicate baseline, during stress, myocardial counts with MIBI SPECT, and integral of LV counts with first pass angiography, respectively. Additionally, standard stress/rest (15)O-water PET to estimate CFR was performed in all patients as standard of reference. RESULTS CFRMIBI increased in conjunction with CFR, but underestimated blood flow at high flow rates. The relationship between CFRMIBI (Y) and CFRPET (X) was well fitted as follows: Y=1.40x(1-exp(1.79/x)) (r=0.84). CONCLUSIONS The index of CFRMIBI reflects the CFR by (15)O-water PET but underestimates flow at high flows, maybe as a reflection of pharmacokinetic limitations of MIBI.
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Range FT, Kies P, Schäfers KP, Breithardt G, Schober O, Wichter T, Schäfers MA. Sex differences in absolute myocardial perfusion. Non-invasive H2(15)O-PET in young healthy adults. Nuklearmedizin 2016; 55:196-202. [PMID: 27437761 DOI: 10.3413/nukmed-0821-16-04] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 06/17/2016] [Indexed: 11/20/2022]
Abstract
AIM To investigate sex differences in myocardial perfusion especially in healthy individuals since former studies are rare and findings are controversial. Participants, methods: 26 subjects were enrolled: 16 healthy women (age: 34 ±7 years) were compared with 10 healthy men (age: 34 ± 3 years; p = ns). Myocardial blood flow (MBF) and coronary vascular resistance (CVR) were quantified at rest, during adenosine infusion and cold-pressor-testing, using positron emission tomography and radioactive-labelled water (H2(15)O-PET). RESULTS Women showed higher MBF than men at rest (1.10 ± 0.18 vs. 0.85 ± 0.20 ml/min/ml; p = 0.003) and cold-stress (1.39 ± 0.38 vs. 1.06 ± 0.28 ml/min/ml; p = 0.026). Corrected for rate-pressure-product, baseline findings maintained significance (1.41 ± 0.33 vs. 1.16 ± 0.19 ml/min/ml; p = 0.024). CVR was lower in women at baseline (81 ± 14 vs. 107 ± 22 mmHg*ml(-1)*min*ml; p = 0.006) and during cold-pressor-testing (71 ± 17 vs. 91 ± 20 mmHg*ml(-1)*min*ml; p = 0.013). Under adenosine neither maximal MBF (4.06 ± 1.0 vs. 3.91 ± 0.88 ml/min/ml; p = ns) nor coronary flow reserve (3.07 ± 1.12 vs. 3.44 ± 0.92; p = ns) nor CVR (24 ± 8 vs. 24 ± 6 mmHg*ml(-1)*min*ml; p = ns) showed sex-related differences. CONCLUSION Women show higher myocardial perfusion and lower coronary vascular resistance than men in physiologic states. Maximum perfusion and vasodilation under adenosine are not sex-specific.
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Affiliation(s)
- Felix T Range
- Dr. med. Felix Range, Universitätsklinikum Düsseldorf, Klinik für Kardiologie, Pneumologie und Angiologie, Moorenstr. 5, 40225 Düsseldorf, Germany, Tel. +49/(0)211/811-88 00, Fax -95 20,
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Williams MC, Mirsadraee S, Dweck MR, Weir NW, Fletcher A, Lucatelli C, MacGillivray T, Golay SK, Cruden NL, Henriksen PA, Uren N, McKillop G, Lima JAC, Reid JH, van Beek EJR, Patel D, Newby DE. Computed tomography myocardial perfusion vs 15O-water positron emission tomography and fractional flow reserve. Eur Radiol 2016; 27:1114-1124. [PMID: 27334015 PMCID: PMC5306314 DOI: 10.1007/s00330-016-4404-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 05/05/2016] [Accepted: 05/12/2016] [Indexed: 11/25/2022]
Abstract
Objectives Computed tomography (CT) can perform comprehensive cardiac imaging. We compared CT coronary angiography (CTCA) and CT myocardial perfusion (CTP) with 15O-water positron emission tomography (PET) and invasive coronary angiography (ICA) with fractional flow reserve (FFR). Methods 51 patients (63 (61–65) years, 80 % male) with known/suspected coronary artery disease (CAD) underwent 320-multidetector CTCA followed by “snapshot” adenosine stress CTP. Of these 22 underwent PET and 47 ICA/FFR. Obstructive CAD was defined as CTCA stenosis >50 % and CTP hypoperfusion, ICA stenosis >70 % or FFR <0.80. Results PET hyperaemic myocardial blood flow (MBF) was lower in obstructive than non-obstructive territories defined by ICA/FFR (1.76 (1.32–2.20) vs 3.11 (2.44–3.79) mL/(g/min), P < 0.001) and CTCA/CTP (1.76 (1.32–2.20) vs 3.12 (2.44–3.79) mL/(g/min), P < 0.001). Baseline and hyperaemic CT attenuation density was lower in obstructive than non-obstructive territories (73 (71–76) vs 86 (84–88) HU, P < 0.001 and 101 (96–106) vs 111 (107–114) HU, P 0.001). PET hyperaemic MBF corrected for rate pressure product correlated with CT attenuation density (r = 0.579, P < 0.001). There was excellent per-patient sensitivity (96 %), specificity (85 %), negative predictive value (90 %) and positive predictive value (94 %) for CTCA/CTP vs ICA/FFR. Conclusion CT myocardial attenuation density correlates with 15O-water PET MBF. CTCA and CTP can accurately identify obstructive CAD. Key Points •CT myocardial perfusion can aid the assessment of suspected coronary artery disease. • CT attenuation density from “snapshot” imaging is a marker of myocardial perfusion. • CT myocardial attenuation density correlates with15O-water PET myocardial blood flow. • CT attenuation density is lower in obstructive territories defined by invasive angiography. • Diagnostic accuracy of CTCA+CTP is comparable to invasive angiography + fractional flow reserve. Electronic supplementary material The online version of this article (doi:10.1007/s00330-016-4404-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michelle C Williams
- University of Edinburgh/British Heart Foundation Centre for Cardiovascular Science, Chancellor's Building, 49 Little France Crescent, Edinburgh, UK, EH16 4SB.
| | - Saeed Mirsadraee
- Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, UK
| | - Marc R Dweck
- University of Edinburgh/British Heart Foundation Centre for Cardiovascular Science, Chancellor's Building, 49 Little France Crescent, Edinburgh, UK, EH16 4SB
| | - Nicholas W Weir
- Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, UK
| | - Alison Fletcher
- Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, UK
| | | | - Tom MacGillivray
- University of Edinburgh/British Heart Foundation Centre for Cardiovascular Science, Chancellor's Building, 49 Little France Crescent, Edinburgh, UK, EH16 4SB
- Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, UK
| | - Saroj K Golay
- University of Edinburgh/British Heart Foundation Centre for Cardiovascular Science, Chancellor's Building, 49 Little France Crescent, Edinburgh, UK, EH16 4SB
| | | | | | - Neal Uren
- Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Graham McKillop
- Department of Radiology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - João A C Lima
- Departments of Medicine and Radiology, Johns Hopkins Hospital, Baltimore, MD, USA
| | - John H Reid
- Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, UK
| | - Edwin J R van Beek
- University of Edinburgh/British Heart Foundation Centre for Cardiovascular Science, Chancellor's Building, 49 Little France Crescent, Edinburgh, UK, EH16 4SB
- Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, UK
| | - Dilip Patel
- Department of Radiology, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - David E Newby
- University of Edinburgh/British Heart Foundation Centre for Cardiovascular Science, Chancellor's Building, 49 Little France Crescent, Edinburgh, UK, EH16 4SB
- Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, UK
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Klein R, Hung GU, Wu TC, Huang WS, Li D, deKemp RA, Hsu B. Feasibility and operator variability of myocardial blood flow and reserve measurements with ⁹⁹mTc-sestamibi quantitative dynamic SPECT/CT imaging. J Nucl Cardiol 2014; 21:1075-88. [PMID: 25280761 DOI: 10.1007/s12350-014-9971-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Accepted: 07/14/2014] [Indexed: 12/16/2022]
Abstract
PURPOSE Myocardial blood flow (MBF) quantification with dynamic SPECT could lead to widespread utilization of MBF imaging in clinical practice with little cost increase over current standard SPECT myocardial perfusion imaging. This work evaluates the feasibility and operator-dependent variability of MBF and flow reserve measurements with (99m)Tc-sestamibi (MIBI) dynamic SPECT imaging using a standard dual-head SPECT camera. METHODS Twenty-eight patients underwent dipyridamole-stress and rest imaging with dynamic SPECT/CT acquisition. Quantitative images were iteratively reconstructed with all physical corrections and then myocardial and arterial blood regions of interest (ROI) were defined semi-automatically. A compartmental model was fitted to these ROI-sampled time-activity-curves, and flow-dependent MIBI extraction correction was applied to derive regional MBF values. Myocardial flow reserve (MFR) was estimated as stress/rest MBF ratio. MBF and MFR in low and high risk populations were evaluated for ability to detect disease. Images were each processed twice (≥7 days apart) by one expert and one novice operator to evaluate intra- and inter-operator variability of MBF and MFR measurement in the three coronary artery vascular territories. RESULTS Mean rest flow, stress flow, and MFR values were 0.83, 1.82 mL·minute(-1)·g(-1), and 2.45, respectively. For stress/rest MFR, the inter-operator reproducibility was r(2) = 0.86 with RPC = 1.1. Stress MBF and MFR were significantly reduced (P < .05) in high risk (n = 9) vs low risk populations (n = 19), indicating ability to detect disease. For expert and novice operators very good intra-operator correlations of r(2) = 0.98 and 0.95 (n = 168, P < .001) were observed for combined rest and stress regional flow values. Bland-Altman reproducibility coefficients (RPC) were 0.25 and 0.47 mL·minute(-1)·g(-1) for the expert and novice operators, respectively (P < .001). Inter-operator correlation was r(2) = 0.91 and Bland-Altman RPC = 0.58 mL·minute(-1)·g(-1) (n = 336). CONCLUSIONS MBF and reserve measurements using (99m)Tc-sestamibi on a traditional, two-headed camera with fast rotation and with quantitative dynamic SPECT appears to be feasible, warranting further investigation.
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Affiliation(s)
- Ran Klein
- University of Ottawa Heart Institute, Cardiac PET Centre, 40 Ruskin St., Ottawa, ON, K1Y 4W7, Canada,
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Harms HJ, Nesterov SV, Han C, Danad I, Leonora R, Raijmakers PG, Lammertsma AA, Knuuti J, Knaapen P. Comparison of clinical non-commercial tools for automated quantification of myocardial blood flow using oxygen-15-labelled water PET/CT. Eur Heart J Cardiovasc Imaging 2013; 15:431-41. [DOI: 10.1093/ehjci/jet177] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Impaired myocardium regeneration with skeletal cell sheets--a preclinical trial for tissue-engineered regeneration therapy. Transplantation 2010; 90:364-72. [PMID: 20555308 DOI: 10.1097/tp.0b013e3181e6f201] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND We hypothesized that autologous skeletal cell (SC) sheets regenerate the infract myocardium in porcine heart as a preclinical trial. METHODS AND RESULTS The impaired heart was created by implantation of ameroid constrictor on left anterior descending for 4 weeks. SCs isolated from leg muscle were cultured and detached from the temperature-responsive domain-coated dishes as single monolayer cell sheet at 20 degrees C. The following therapies were conducted: SC sheets (SC group, n=5); sham (C group n=5). Echocardiography demonstrated that cardiac performance was significantly improved in the SC group 3 and 6 months after operation (fractional area shortening, 3 months; SC vs. C=49.5+/-2.8 vs. 24.6+/-2.0%, P<0.05) and left ventricle dilatation was well attenuated in the SC group. Color kinesis index showed that distressed regional diastolic and systolic function in infarcted anterior wall was significantly recovered (SC vs. C=57.4+/-8.6 vs. 30.2+/-4.7%, P<0.05, diastolic: 58.5+/-4.5 vs. 35.4+/-6.6%, P<0.05, systolic). Factor VIII immunostains demonstrated that vascular density was significantly higher in the SC group than the C group. And % fibrosis and cell diameter were significantly lower in the SC group. And hematoxylin-eosin staining depicted that skeletal origin cells and well-developed-layered smooth muscle cells were detected in the implanted area. Positron emission tomography showed better myocardial perfusion and more viable myocardial tissue in the distressed myocardium receiving SC sheets compared with the myocardium receiving no sheets. CONCLUSIONS SC sheet implantation improved cardiac function by attenuating the cardiac remodeling in the porcine ischemic myocardium, suggesting a promising strategy for myocardial regeneration therapy in the impaired myocardium.
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Klein R, Beanlands RSB, deKemp RA. Quantification of myocardial blood flow and flow reserve: Technical aspects. J Nucl Cardiol 2010; 17:555-70. [PMID: 20596841 DOI: 10.1007/s12350-010-9256-9] [Citation(s) in RCA: 119] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ran Klein
- National Cardiac PET Centre, University of Ottawa Heart Institute, 40 Ruskin St., Ottawa, ON, K1Y 4W7, Canada
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11
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Maroy R, Boisgard R, Comtat C, Jego B, Fontyn Y, Jan S, Dubois A, Trébossen R, Tavitian B. Quantitative organ time activity curve extraction from rodent PET images without anatomical prior. Med Phys 2010; 37:1507-17. [PMID: 20443471 DOI: 10.1118/1.3327454] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Numerous new drug candidates fail because of inadequate pharmacokinetics. Positron emission tomography (PET) enables the noninvasive characterization of the drug in humans and animals. The aim of the present work was the comparison of methods for the extraction of organ time activity curves from rodent PET images without requiring resort to anatomical information. METHODS The rodent organs were segmented using the local means analysis method and the accuracy of the time activity curve (TAC) estimated using four methods was compared: The mean TAC (Mean), the TAC computed in a selection of organ voxels (ROIopt), and the TAC corrected for partial volume effect using the geometric transfer matrix (GTM) method. The accuracy of the TAC estimated using the three methods was compared on phantom simulations and on experimental data sets on mice injected with fluorothymidine. RESULTS The segmentation quality measured on phantom simulation was 80% of overlap between segmented and gold standard organs. On the phantom simulations, the error on the TAC estimation on phantom simulations was lower for ROIopt (8%) than using the GTM (18%) and the Mean (27%) methods. Similar results were achieved on the experimental data sets: ROIopt (5.8%), GTM (9.7%), and Mean (12%). CONCLUSIONS The new ROI optimization method was fast and precise for all homogeneous organs, while mean organ TAC computation led as expected to important errors. GTM improved the quantification accuracy but showed instabilities due to segmentation errors and to small organ sizes. Partial volume effect correction or limitation is thus possible for the extraction of precise organ TACs without requiring either manual delineation or an anatomical modality.
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Affiliation(s)
- R Maroy
- Commissariat à l'Energie Atomique, Service Hospitalier Frédéric Joliot, 91401 Orsay, France.
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Bentourkia M, Noel PD. Simplification of analysis procedures in inter-subject studies with cardiac PET imaging. Comput Med Imaging Graph 2004; 28:279-87. [PMID: 15249073 DOI: 10.1016/j.compmedimag.2004.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2003] [Revised: 02/04/2004] [Indexed: 11/16/2022]
Abstract
Quantitative analysis in positron emission tomography imaging usually necessitates several studies carried out under the same protocol in order to get functional or metabolic parameter values with low variations. Apart from subject preparation and measurements in similar conditions, the data analysis should be done as uniformly as possible. In this work we report PET data obtained in normal and ischemic rats, measured with (13)N-ammonia and (11)C-acetate to extract myocardial blood flow and oxygen consumption, and analysed with the usual region of interest (ROI) drawing method in each rat individually, in comparison to a new method based on resampling all the rat heart images to a common model, then the ROIs are drawn once and copied onto each rat image sequence.
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Affiliation(s)
- M'hamed Bentourkia
- Department of Nuclear Medicine and Radiobiology, 3001, 12th Avenue North, University of Sherbrooke, Sherbrooke, Québec J1H 5N4, Canada.
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Knaapen P, Boellaard R, Götte MJW, van der Weerdt AP, Visser CA, Lammertsma AA, Visser FC. The perfusable tissue index: a marker of myocardial viability. J Nucl Cardiol 2004; 10:684-91. [PMID: 14668782 DOI: 10.1016/s1071-3581(03)00656-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Paul Knaapen
- Department of Cardiology, University Medical Center, Amsterdam, The Netherlands.
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Abstract
In this review, the current imaging methods of assessing tumor perfusion are discussed and compared. Because most of the techniques depend on the administration of contrast agents, we first consider some general principles underlying the fate of contrast agents and their behavior inside the unique vascular environment of tumors.
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Affiliation(s)
- Peter L Choyke
- Department of Radiology, Warren Grant Magnusen Clinical Center, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892-1182, USA
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Agostini D, Iida H, Takahashi A, Tamura Y, Henry Amar M, Ono Y. Regional myocardial metabolic rate of oxygen measured by O2-15 inhalation and positron emission tomography in patients with cardiomyopathy. Clin Nucl Med 2001; 26:41-9. [PMID: 11139052 DOI: 10.1097/00003072-200101000-00010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Positron emission tomography (PET) metabolic studies have investigated the pathways involved in fatty acid, glucose, and oxidative metabolism in cardiomyopathy and the impairments that occur in the damaged myocardium, but none have provided absolute quantitative variables. Recently, quantitative measurements of the metabolic rate of oxygen (MMRO2) and oxygen extraction fraction (OEF) using O2-15-labeled oxygen gas have been validated in animals and healthy volunteers. The purposes of the current study were to measure MMRO2 and OEF in cardiomyopathy with left ventricular (LV) dysfunction. METHODS The authors selected 25 study participants: 16 patients (10 with ischemic and 6 with dilated) cardiomyopathy with LV dysfunction, and 9 healthy volunteers. As evaluated by echocardiography, LV ejection fraction (LVEF) was decreased in patients (35%+/-9% vs. 65%+/-5%, P<0.01). The PET protocol consisted of transmission, C O2-15 static, H2 O-15 dynamic, and O2-15 gas inhalation steady state scans. An entire myocardial region of interest was drawn to encompass the entire LV myocardium on three midventricular slices in each participant. RESULTS Data showed in patients with dilated cardiomyopathy significant reductions of MMRO2 (0.051+/-0.02 ml x min(-1) x g(-1) vs. 0.108+/-0.02 ml x min(-1) x g(-1), p = 0.01) and OEF (0.55+/-0.15 vs. 0.71+/-0.08, P = 0.01) when compared with healthy volunteers. Furthermore, OEF decreased significantly in lateral and inferior walls. Significant correlations were observed among OEF and the rate-pressure product (RPP) (P = 0.02), LVEF (P<0.001), MMRO2 and RPP (P = 0.04), and LVEF (P = 0.05). In patients with ischemic cardiomyopathy, MMRO2 was significantly reduced (0.039+/-0.02 ml x min(-1) x g(-1) vs. 0.108+/-0.02 ml x min(-1) x g(-1); p = 0.005) but not OEF (0.63+/-0.2 vs. 0.71+/-0.08; P = NS), when compared with healthy volunteers. Significant correlations were observed among OEF and RPP (P = 0.03), LVEF (P = 0.002), MMRO2 and RPP (P<0.01), and LVEF (P = 0.03). CONCLUSIONS These data show that O2-15 gas inhalation and PET allow myocardial MMRO2 and OEF to be measured in patients with cardiomyopathy.
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Affiliation(s)
- D Agostini
- Service de Médecine Nucléaire, CHU C te de Nacre, Caen, France.
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Tadamura E, Iida H, Matsumoto K, Mamede M, Kubo S, Toyoda H, Shiozaki T, Mukai T, Magata Y, Konishi J. Comparison of myocardial blood flow during dobutamine-atropine infusion with that after dipyridamole administration in normal men. J Am Coll Cardiol 2001; 37:130-6. [PMID: 11153727 DOI: 10.1016/s0735-1097(00)01043-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The present study was designed to compare the absolute myocardial blood flow (MBF) after intravenous dipyridamole infusion with that during dobutamine-atropine administration in normal healthy male volunteers. BACKGROUND Both safety and usefulness of dobutamine-atropine stress in myocardial perfusion imaging have been reported. However, no information exists on whether the magnitude ofhyperemia achieved with dipyridamole and dobutamine-atropine is comparable. METHODS Myocardial blood flow was measured with positron emission tomography and 15O-labeled water in 20 healthy young men (23 +/- 3 years) 1) at baseline, 2) after dipyridamole infusion (0.56 mg/kg over 4 min), and 3) during dobutamine (40 microg/kg/min) and atropine (0.25 to 1.0 mg) infusion. RESULTS The MBF was significantly increased during dipyridamole infusion and during dobutamine-atropine stress compared with at rest (4.33 +/- 1.23 and 5.89 +/- 1.58 vs. 0.67 +/- 0.16 ml/min/g, respectively, p < 0.0001). Moreover, dobutamine-atropine infusion produced greater MBF compared with dipyridamole (p = 0.0011), while coronary vascular resistance did not differ significantly after dipyridamole administration and during dobutamine-atropine infusion (17.6 +/- 7.9 vs. 18.6 +/- 5.6 mm Hg/[ml/min/g], respectively). CONCLUSIONS Near maximal coronary vasodilatation caused by dipyridamole is attainable using dobutamine and atropine in young healthy volunteers. Dobutamine in conjunction with atropine is no less effective than dipyridamole in producing myocardial hyperemia.
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Affiliation(s)
- E Tadamura
- Department of Nuclear Medicine and Diagnostic Imaging, Kyoto University Graduate School of Medicine, Japan.
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