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Han Y, Ahmed AI, Hayden C, Jung AK, Saad JM, Spottiswoode B, Nabi F, Al-Mallah MH. Change in positron emission tomography perfusion imaging quality with a data-driven motion correction algorithm. J Nucl Cardiol 2022; 29:3426-3431. [PMID: 35275348 DOI: 10.1007/s12350-021-02902-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 12/17/2021] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Cardiac motion frequently reduces the interpretability of PET images. This study utilized a prototype data-driven motion correction (DDMC) algorithm to generate corrected images and compare DDMC images with non-corrected images (NMC) to evaluate image quality and change of perfusion defect size and severity. METHODS Rest and stress images with NMC and DDMC from 40 consecutive patients with motion were rated by 2 blinded investigators on a 4-point visual ordinal scale (0: minimal motion; 1: mild motion; 2: moderate motion; 3: severe motion/uninterpretable). Motion was also quantified using Dwell Fraction, which is the fraction of time the motion vector shows the heart to be within 6 mm of the corrected position and was derived from listmode data of NMC images. RESULTS Minimal motion was seen in 15% of patients, while 40%, 30%, and 15% of patients had mild moderate and severe motion, respectively. All corrected images showed an improvement in quality and were interpretable after processing. This was confirmed by a significant correlation (Spearman's correlation coefficient 0.626, P < .001) between machine measurement of motion quantification and physician interpretation. CONCLUSION The novel DDMC algorithm improved quality of cardiac PET images with motion. Correlation between machine measurement of motion quantification and physician interpretation was significant.
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Affiliation(s)
- Yushui Han
- Houston Methodist Debakey Heart and Vascular Center, 6550 Fannin Street, Smith Tower-Suite 1801, Houston, TX, 77030, USA
| | - Ahmed Ibrahim Ahmed
- Houston Methodist Debakey Heart and Vascular Center, 6550 Fannin Street, Smith Tower-Suite 1801, Houston, TX, 77030, USA
| | | | - Aaron K Jung
- Siemens Medical Solutions USA, Inc., Knoxville, TN, USA
| | - Jean Michel Saad
- Houston Methodist Debakey Heart and Vascular Center, 6550 Fannin Street, Smith Tower-Suite 1801, Houston, TX, 77030, USA
| | | | - Faisal Nabi
- Houston Methodist Debakey Heart and Vascular Center, 6550 Fannin Street, Smith Tower-Suite 1801, Houston, TX, 77030, USA
| | - Mouaz H Al-Mallah
- Houston Methodist Debakey Heart and Vascular Center, 6550 Fannin Street, Smith Tower-Suite 1801, Houston, TX, 77030, USA.
- Medicine and Cardiology, Weill Cornell Medical College, New York, USA.
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2
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Nye JA, Cooke CD. Accounting for residual activity in the estimate of myocardial blood flow with PET. J Nucl Cardiol 2022; 29:2271-2273. [PMID: 34918236 DOI: 10.1007/s12350-021-02873-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 11/08/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Jonathon A Nye
- Department of Radiology and Imaging Sciences, Emory School of Medicine, Emory University, 1841 Clifton Rd. NE, Atlanta, GA, 30329, USA.
| | - C David Cooke
- Department of Radiology and Imaging Sciences, Emory School of Medicine, Emory University, 1841 Clifton Rd. NE, Atlanta, GA, 30329, USA
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3
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Van Tosh A, Cao JJ, Votaw JR, Cooke CD, Palestro CJ, Nichols KJ. Clinical implications of compromised 82Rb PET data acquisition. J Nucl Cardiol 2022; 29:2583-2594. [PMID: 34417670 DOI: 10.1007/s12350-021-02774-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 07/26/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND We wished to document the prevalence and quantitative effects of compromised 82Rb PET data acquisitions on myocardial flow reserve (MFR). METHODS AND RESULTS Data were analyzed retrospectively for 246 rest and regadenoson-stress studies of 123 patients evaluated for known or suspected CAD. An automated injector delivered pre-determined activities of 82Rb. Automated quality assurance algorithms identified technical problems for 7% (9/123) of patients. Stress data exhibited 2 instances of scanner saturation, 1 blood peak detection, 1 blood peak width, 1 gradual patient motion, and 2 abrupt patient motion problems. Rest data showed 1 instance of blood peak width and 2 abrupt patient motion problems. MFR was lower for patients with technical problems flagged by the quality assurance algorithms than those without technical problems (1.5 ± 0.5 versus 2.1 ± 0.7, P = 0.01), even though rest and stress ejection fraction, asynchrony and relative myocardial perfusion measures were similar for these two groups (P > 0.05), suggesting that MFR accuracy was adversely affected by technical errors. CONCLUSION It is important to verify integrity of 82Rb data to ensure MFR computation quality.
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Affiliation(s)
- Andrew Van Tosh
- St. Francis Hospital, Roslyn, NY, USA
- Research Department, St. Francis Hospital, 100 Port Washington Blvd., Roslyn, NY, 11576-1348, USA
| | | | | | | | | | - Kenneth J Nichols
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
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Armstrong IS, Memmott MJ, Hayden C, Arumugam P. The prevalence of image degradation due to motion in rest-stress rubidium-82 imaging on a SiPM PET-CT system. J Nucl Cardiol 2022; 29:1596-1606. [PMID: 33608851 DOI: 10.1007/s12350-021-02531-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/07/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Motion of the heart is known to affect image quality in cardiac PET. The prevalence of motion blurring in routine cardiac PET is not fully appreciated due to challenges identifying subtle motion artefacts. This study utilizes a recent prototype Data-Driven Motion Correction (DDMC) algorithm to generate corrected images that are compared with non-corrected images to identify visual differences in relative rubidium-82 perfusion images due to motion. METHODS 300 stress and 300 rest static images were reconstructed with DDMC and without correction (NMC). The 600 DDMC/NMC image pairs were assigned Visual Difference Score (VDS). The number of non-diagnostic images were noted. A "Dwell Fraction" (DF) was derived from the data to quantify motion and predict image degradation. RESULTS Motion degradation (VDS = 1 or 2) was evident in 58% of stress images and 33% of rest images. Seven NMC images were non-diagnostic-these originated from six studies giving a 2% rate of non-diagnostic studies due to motion. The DF metric was able to effectively predict image degradation. The DDMC heart identification and tracking was successful in all images. CONCLUSION Motion degradation is present in almost half of all relative perfusion images. The DDMC algorithm is a robust tool for predicting, assessing and correcting image degradation.
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Affiliation(s)
- Ian S Armstrong
- Nuclear Medicine, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK.
| | - Matthew J Memmott
- Nuclear Medicine, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK
| | - Charles Hayden
- Siemens Medical Solutions USA, Inc., Molecular Imaging, Knoxville, TN, USA
| | - Parthiban Arumugam
- Nuclear Medicine, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK
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5
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Nordström J, Harms HJ, Kero T, Sörensen J, Lubberink M. Influence of patient motion on quantitative accuracy in cardiac 15O-water positron emission tomography. J Nucl Cardiol 2022; 29:1742-1752. [PMID: 33655448 PMCID: PMC9345798 DOI: 10.1007/s12350-021-02550-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 01/18/2021] [Indexed: 10/26/2022]
Abstract
BACKGROUND Patient motion is a common problem during cardiac PET. The purpose of the present study was to investigate to what extent motions influence the quantitative accuracy of cardiac 15O-water PET/CT and to develop a method for automated motion detection. METHOD Frequency and magnitude of motion was assessed visually using data from 50 clinical 15O-water PET/CT scans. Simulations of 4 types of motions with amplitude of 5 to 20 mm were performed based on data from 10 scans. An automated motion detection algorithm was evaluated on clinical and simulated motion data. MBF and PTF of all simulated scans were compared to the original scan used as reference. RESULTS Patient motion was detected in 68% of clinical cases by visual inspection. All observed motions were small with amplitudes less than half the LV wall thickness. A clear pattern of motion influence was seen in the simulations with a decrease of myocardial blood flow (MBF) in the region of myocardium to where the motion was directed. The perfusable tissue fraction (PTF) trended in the opposite direction. Global absolute average deviation of MBF was 3.1% ± 1.8% and 7.3% ± 6.3% for motions with maximum amplitudes of 5 and 20 mm, respectively. Automated motion detection showed a sensitivity of 90% for simulated motions ≥ 10 mm but struggled with the smaller (≤ 5 mm) simulated (sensitivity 45%) and clinical motions (accuracy 48%). CONCLUSION Patient motion can impair the quantitative accuracy of MBF. However, at typically occurring levels of patient motion, effects are similar to or only slightly larger than inter-observer variability, and downstream clinical effects are likely negligible.
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Affiliation(s)
- Jonny Nordström
- Department of Surgical Sciences/Nuclear Medicine & PET, Uppsala University, Uppsala, Sweden.
- Centre for Research and Development, Uppsala/Gävleborg County, Gävle, Sweden.
| | - Hendrik J Harms
- Department of Surgical Sciences/Nuclear Medicine & PET, Uppsala University, Uppsala, Sweden
- MedTrace Pharma A/S, Lyngby, Denmark
| | - Tanja Kero
- Department of Surgical Sciences/Nuclear Medicine & PET, Uppsala University, Uppsala, Sweden
- Medical Imaging Centre, Uppsala University Hospital, Uppsala, Sweden
| | - Jens Sörensen
- Department of Surgical Sciences/Nuclear Medicine & PET, Uppsala University, Uppsala, Sweden
- Medical Imaging Centre, Uppsala University Hospital, Uppsala, Sweden
| | - Mark Lubberink
- Department of Surgical Sciences/Nuclear Medicine & PET, Uppsala University, Uppsala, Sweden
- Medical Physics, Uppsala University Hospital, Uppsala, Sweden
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6
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Lee BC. Cardiac 15O-water PET: Does mismatched attenuation correction not matter? J Nucl Cardiol 2022; 29:1129-1131. [PMID: 33751477 DOI: 10.1007/s12350-021-02573-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 02/08/2021] [Indexed: 12/25/2022]
Affiliation(s)
- Benjamin C Lee
- Dalio Institute of Cardiovascular Imaging, Weill Cornell Medicine/NewYork-Presbyterian, New York, NY, USA.
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7
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Koenders SS, van Dalen JA, van Dijk JD. The next step in improving (semi-)quantitative MPI PET. J Nucl Cardiol 2022; 29:461-463. [PMID: 32940888 DOI: 10.1007/s12350-020-02346-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 08/14/2020] [Indexed: 10/23/2022]
Affiliation(s)
- S S Koenders
- Department of Nuclear Medicine, Isala Hospital, PO Box 10400, 8000 GK, Zwolle, The Netherlands
- Technical Medical Center, University of Twente, Enschede, The Netherlands
| | - J A van Dalen
- Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands
| | - J D van Dijk
- Department of Nuclear Medicine, Isala Hospital, PO Box 10400, 8000 GK, Zwolle, The Netherlands.
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Armstrong IS, Hayden C, Memmott MJ, Arumugam P. A preliminary evaluation of a high temporal resolution data-driven motion correction algorithm for rubidium-82 on a SiPM PET-CT system. J Nucl Cardiol 2022; 29:56-68. [PMID: 32440990 PMCID: PMC8873161 DOI: 10.1007/s12350-020-02177-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 04/24/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND In myocardial perfusion PET, images are acquired during vasodilator stress, increasing the likelihood of intra-frame motion blurring of the heart in reconstructed static images to assess relative perfusion. This work evaluated a prototype data-driven motion correction (DDMC) algorithm designed specifically for cardiac PET. METHODS A cardiac torso phantom, with a solid defect, was scanned stationary and being manually pulled to-and-fro in the axial direction with a random motion. Non-motion-corrected (NMC) and DDMC images were reconstructed. Total perfusion deficit was measured in the defect and profiles through the cardiac insert were defined. In addition, 46 static perfusion images from 36 rubidium-82 MPI patients were selected based upon a perception of motion blurring in the images. NMC and DDMC images were reconstructed, blinded, and scored on image quality and perceived motion. RESULTS Phantom data demonstrated near-perfect recovery of myocardial wall visualization and defect quantification with DDMC compared with the stationary phantom. Quality of clinical images was NMC: 10 non-diagnostic, 31 adequate, and 5 good; DDMC images: 0 non-diagnostic, 6 adequate, and 40 good. CONCLUSION The DDMC algorithm shows great promise in rubidium MPI PET with substantial improvements in image quality and the potential to salvage images considered non-diagnostic due to significant motion blurring.
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Affiliation(s)
- Ian S Armstrong
- Nuclear Medicine, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK.
| | - Charles Hayden
- Molecular Imaging, Siemens Medical Solutions USA, Inc., Knoxville, TN, USA
| | - Matthew J Memmott
- Nuclear Medicine, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK
| | - Parthiban Arumugam
- Nuclear Medicine, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK
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9
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Presotto L. The long fight against motion artifacts in cardiac PET. J Nucl Cardiol 2022; 29:69-71. [PMID: 32557239 DOI: 10.1007/s12350-020-02232-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 06/08/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Luca Presotto
- Nuclear Medicine Unit, IRCCS Ospedale San Raffaele, Milano, Italy.
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10
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Lassen ML, Slomka PJ. Myocardial blood flow: Is motion correction necessary? J Nucl Cardiol 2021; 28:1347-1348. [PMID: 31541429 DOI: 10.1007/s12350-019-01896-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 09/05/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Martin Lyngby Lassen
- Artificial Intelligence in Medicine Program, Cedars-Sinai Medical Center, 8700 Beverly Blvd. Ste. A047, Los Angeles, CA, 90048, USA.
| | - Piotr J Slomka
- Artificial Intelligence in Medicine Program, Cedars-Sinai Medical Center, 8700 Beverly Blvd. Ste. A047, Los Angeles, CA, 90048, USA
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11
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Armstrong IS, Memmott MJ, Saint KJ, Saillant A, Hayden C, Arumugam P. Assessment of motion correction in dynamic rubidium-82 cardiac PET with and without frame-by-frame adjustment of attenuation maps for calculation of myocardial blood flow. J Nucl Cardiol 2021; 28:1334-1346. [PMID: 31388967 DOI: 10.1007/s12350-019-01834-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/16/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Patient motion during pharmacological stressing can have substantial impact on myocardial blood flow (MBF) estimated from dynamic PET. This work evaluated a motion correction algorithm with and without adjustment of the PET attenuation map. METHODS Frame-by-frame motion correction was performed by three users on 30 rubidium-82 studies. Data were divided equally into three groups of motion severity [mild (M1), moderate (M2) and severe (M3)]. MBF data were compared for non-motion corrected (NC), motion-corrected-only (MC) and with adjustment of the attenuation map (MCAC). Percentage differences of MBF were calculated in the coronary territories and 17-segment polar plots. Polar plots of spill-over were also generated from the data. RESULTS Median differences of 23% were seen in the RCA and 18% for the LAD in the M3 category for MC vs NC images. Differences for MCAC vs MC images were considerably smaller and typically < 10%. Spill-over plots for MC and MCAC were notably more uniform compared with NC images. CONCLUSION Motion correction for dynamic rubidium data is desirable for future MBF software updates. Adjustment of the PET attenuation map results in only marginal differences and therefore is unlikely to be an essential requirement. Assessing the uniformity of spill-over plots is a useful visual aid for verifying motion correction techniques.
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Affiliation(s)
- Ian S Armstrong
- Nuclear Medicine, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK.
| | - Matthew J Memmott
- Nuclear Medicine, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK
| | - Kimberley J Saint
- Nuclear Medicine, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK
| | - Antoine Saillant
- Siemens Medical Solutions USA, Inc, Molecular Imaging, Knoxville, TN, USA
| | - Charles Hayden
- Siemens Medical Solutions USA, Inc, Molecular Imaging, Knoxville, TN, USA
| | - Parthiban Arumugam
- Nuclear Medicine, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK
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12
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Nye JA, Piccinelli M, Hwang D, David Cooke C, Paeng JC, Lee JM, Cho SG, Folks R, Bom HS, Koo BK, Garcia EV. Dynamic cardiac PET motion correction using 3D normalized gradient fields in patients and phantom simulations. Med Phys 2021; 48:5072-5084. [PMID: 34174095 DOI: 10.1002/mp.15059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/06/2021] [Accepted: 06/09/2021] [Indexed: 11/09/2022] Open
Abstract
This work expands on the implementation of three-dimensional (3D) normalized gradient fields to correct for whole-body motion and cardiac creep in [N-13]-ammonia patient studies and evaluates its accuracy using a dynamic phantom simulation model. METHODS A full rigid-body algorithm was developed using 3D normalized gradient fields including a multi-resolution step and sampling off the voxel grid to reduce interpolation artifacts. Optimization was performed using a weighted similarity metric that accounts for opposing gradients between images of blood pool and perfused tissue without the need for segmentation. Forty-three retrospective dynamic [N-13]-ammonia PET/CT rest/adenosine-stress patient studies were motion corrected and the mean motion parameters plotted at each frame time point. Motion correction accuracy was assessed using a comprehensive dynamic XCAT simulation incorporating published physiologic parameters of the heart's trajectory following adenosine infusion as well as corrupted attenuation correction commonly observed in clinical studies. Accuracy of the algorithm was assessed objectively by comparing the errors between isosurfaces and centers of mass of the motion corrected XCAT simulations. RESULTS In the patient studies, the overall mean cranial-to-caudal translation was 7 mm at stress over the duration of the adenosine infusion. Noninvasive clinical measures of relative flow reserve and myocardial flow reserve were highly correlated with their invasive analogues. Motion correction accuracy assessed with the XCAT simulations showed an error of <1 mm in late perfusion frames that broadened gradually to <3 mm in earlier frames containing blood pool. CONCLUSION This work demonstrates that patients undergoing [N-13]-ammonia dynamic PET/CT exhibit a large cranial-to-caudal translation related to cardiac creep primarily at stress and to a lesser extent at rest, which can be accurately corrected by optimizing their 3D normalized gradient fields. Our approach provides a solution to the challenging condition where the image intensity and its gradients are opposed without the need for segmentation and remains robust in the presence of PET-CT mismatch.
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Affiliation(s)
- Jonathon A Nye
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, USA
| | - Marina Piccinelli
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, USA
| | - Doyeon Hwang
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Charles David Cooke
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, USA
| | - Jin Chul Paeng
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea
| | - Joo Myung Lee
- Samsung Medical Center, Heart Vascular Stroke Institute, Seoul, Korea
| | - Sang-Geon Cho
- Department of Nuclear Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Russell Folks
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, USA
| | - Hee-Seung Bom
- Department of Nuclear Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Bon-Kwon Koo
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Ernest V Garcia
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, USA
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Lu Y, Liu C. Patient motion correction for dynamic cardiac PET: Current status and challenges. J Nucl Cardiol 2020; 27:1999-2002. [PMID: 30421380 DOI: 10.1007/s12350-018-01513-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 10/29/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Yihuan Lu
- Department of Radiology and Biomedical Imaging, Yale University, 789 Howard Ave., New Haven, CT, 06519-1368, USA
| | - Chi Liu
- Department of Radiology and Biomedical Imaging, Yale University, 789 Howard Ave., New Haven, CT, 06519-1368, USA.
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14
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EANM procedural guidelines for PET/CT quantitative myocardial perfusion imaging. Eur J Nucl Med Mol Imaging 2020; 48:1040-1069. [PMID: 33135093 PMCID: PMC7603916 DOI: 10.1007/s00259-020-05046-9] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 09/17/2020] [Indexed: 12/19/2022]
Abstract
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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15
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Lee BC, Moody JB, Poitrasson-Rivière A, Melvin AC, Weinberg RL, Corbett JR, Ficaro EP, Murthy VL. Blood pool and tissue phase patient motion effects on 82rubidium PET myocardial blood flow quantification. J Nucl Cardiol 2019; 26:1918-1929. [PMID: 29572594 PMCID: PMC6151305 DOI: 10.1007/s12350-018-1256-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 03/05/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Patient motion can lead to misalignment of left ventricular volumes of interest and subsequently inaccurate quantification of myocardial blood flow (MBF) and flow reserve (MFR) from dynamic PET myocardial perfusion images. We aimed to identify the prevalence of patient motion in both blood and tissue phases and analyze the effects of this motion on MBF and MFR estimates. METHODS We selected 225 consecutive patients that underwent dynamic stress/rest rubidium-82 chloride (82Rb) PET imaging. Dynamic image series were iteratively reconstructed with 5- to 10-second frame durations over the first 2 minutes for the blood phase and 10 to 80 seconds for the tissue phase. Motion shifts were assessed by 3 physician readers from the dynamic series and analyzed for frequency, magnitude, time, and direction of motion. The effects of this motion isolated in time, direction, and magnitude on global and regional MBF and MFR estimates were evaluated. Flow estimates derived from the motion corrected images were used as the error references. RESULTS Mild to moderate motion (5-15 mm) was most prominent in the blood phase in 63% and 44% of the stress and rest studies, respectively. This motion was observed with frequencies of 75% in the septal and inferior directions for stress and 44% in the septal direction for rest. Images with blood phase isolated motion had mean global MBF and MFR errors of 2%-5%. Isolating blood phase motion in the inferior direction resulted in mean MBF and MFR errors of 29%-44% in the RCA territory. Flow errors due to tissue phase isolated motion were within 1%. CONCLUSIONS Patient motion was most prevalent in the blood phase and MBF and MFR errors increased most substantially with motion in the inferior direction. Motion correction focused on these motions is needed to reduce MBF and MFR errors.
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Affiliation(s)
- Benjamin C Lee
- INVIA Medical Imaging Solutions, 3025 Boardwalk St., Suite 200, Ann Arbor, MI, 8108, USA.
| | - Jonathan B Moody
- INVIA Medical Imaging Solutions, 3025 Boardwalk St., Suite 200, Ann Arbor, MI, 8108, USA
| | | | - Amanda C Melvin
- Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Richard L Weinberg
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - James R Corbett
- INVIA Medical Imaging Solutions, 3025 Boardwalk St., Suite 200, Ann Arbor, MI, 8108, USA
- Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Edward P Ficaro
- INVIA Medical Imaging Solutions, 3025 Boardwalk St., Suite 200, Ann Arbor, MI, 8108, USA
- Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Venkatesh L Murthy
- Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, MI, USA
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16
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Armstrong IS, Memmott MJ. A tale of two phases: Can the worst of scans become the best of scans with motion correction? J Nucl Cardiol 2019; 26:1930-1933. [PMID: 29777483 DOI: 10.1007/s12350-018-1305-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 04/30/2018] [Indexed: 10/16/2022]
Affiliation(s)
- Ian S Armstrong
- Nuclear Medicine Centre, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK.
| | - Matthew J Memmott
- Nuclear Medicine Centre, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK
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17
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Koenders SS, van Dijk JD, Jager PL, Ottervanger JP, Slump CH, van Dalen JA. Impact of regadenoson-induced myocardial creep on dynamic Rubidium-82 PET myocardial blood flow quantification. J Nucl Cardiol 2019; 26:719-728. [PMID: 30788758 PMCID: PMC6517358 DOI: 10.1007/s12350-019-01649-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 04/24/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Repositioning of the heart during myocardial perfusion imaging (MPI) using Rubidium-82 (Rb-82) PET may occur when using regadenoson. Our aim was to determine the prevalence and the effect of correcting for this myocardial creep on myocardial blood flow (MBF) quantification. METHODS We retrospectively included 119 consecutive patients who underwent dynamic rest- and regadenoson-induced stress MPI using Rb-82 PET. The presence of myocardial creep was visually assessed in the dynamic stress PET series by identifying differences between the automatically drawn myocardium contour and the activity. Uncorrected and corrected stress MBFs were compared for the three vascular territories (LAD, LCX, and RCA) and for the whole myocardium. RESULTS Myocardial creep was observed in 52% of the patients during stress. Mean MBF values decreased after correction in the RCA from 4.0 to 2.7 mL/min/g (P < 0.001), in the whole myocardium from 2.7 to 2.6 mL/min/g (P = 0.01), and increased in the LAD from 2.5 to 2.6 mL/min/g (P = 0.03) and remained comparable in the LCX (P = 0.3). CONCLUSIONS Myocardial creep is a frequent phenomenon when performing regadenoson-induced stress Rb-82 PET and has a significant impact on MBF values, especially in the RCA territory. As this may hamper diagnostic accuracy, myocardial creep correction seems necessary for reliable quantification.
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Affiliation(s)
- S S Koenders
- Department of Nuclear Medicine, Isala hospital, PO Box 10400, 8000 GK, Zwolle, The Netherlands.
- MIRA: Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
| | - J D van Dijk
- Department of Nuclear Medicine, Isala hospital, PO Box 10400, 8000 GK, Zwolle, The Netherlands
| | - P L Jager
- Department of Nuclear Medicine, Isala hospital, PO Box 10400, 8000 GK, Zwolle, The Netherlands
| | - J P Ottervanger
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands
| | - C H Slump
- MIRA: Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - J A van Dalen
- Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands
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18
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Cremer PC, DiFilippo FP, Cerqueira MD. Creeping towards broader clinical application of PET myocardial blood flow quantification. J Nucl Cardiol 2019; 26:735-737. [PMID: 30793250 DOI: 10.1007/s12350-019-01651-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 06/21/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Paul C Cremer
- Department of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
| | - Frank P DiFilippo
- Department of Nuclear Medicine, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, 44195, USA
| | - Manuel D Cerqueira
- Department of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Department of Nuclear Medicine, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, 44195, USA
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19
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van Dijk JD, Jager PL, Ottervanger JP, Slump CH, van Dalen JA. No need for frame-wise attenuation correction in dynamic Rubidium-82 PET for myocardial blood flow quantification. J Nucl Cardiol 2019; 26:738-745. [PMID: 30790203 DOI: 10.1007/s12350-019-01654-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 01/29/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Regadenoson-induced stress causes a repositioning of the heart, myocardial creep, in half of the patients undergoing Rubidium-82 (Rb-82) positron emission tomography (PET). As a result, misalignment of dynamic PET and computer tomography (CT) may occur, possibly affecting CT-based attenuation correction (AC) and thereby PET-based myocardial blood flow (MBF) quantification. Our aim was to determine the need for frame-wise PET-CT AC to obtain reliable MBF measurements. METHODS 31 Out of 64 consecutive patients had myocardial creep during regadenoson-induced stress Rb-82 PET-CT and were included. Prior to PET image reconstruction, we applied two AC methods; single PET-CT alignment and frame-wise alignment in which PET time-frames with myocardial creep were individually co-registered with CT. The PET-CT misalignment was then quantified and MBFs for the three vascular territories and whole myocardium were calculated and compared between both methods. RESULTS The magnitude of misalignment due to myocardial creep was 13.8 ± 4.5 mm in caudal-cranial direction, 1.8 ± 2.1 mm in medial-lateral and 2.5 ± 1.8 mm in anterior-posterior direction. Frame-wise PET-CT registration did not result in different MBF measurements (P ≥ .07) and the magnitude of misalignment and MBF differences did not correlate (P ≥ .58). CONCLUSION There is no need for frame-wise AC in dynamic Rb-82 PET for MBF quantification. Single alignment seems sufficient in patients with myocardial creep.
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Affiliation(s)
- J D van Dijk
- Department of Nuclear Medicine, Isala Hospital, PO Box 10400, 8000 GK, Zwolle, The Netherlands.
| | - P L Jager
- Department of Nuclear Medicine, Isala Hospital, PO Box 10400, 8000 GK, Zwolle, The Netherlands
| | - J P Ottervanger
- Department of Cardiology, Isala Hospital, PO Box 10400, 8000 GK, Zwolle, The Netherlands
| | - C H Slump
- MIRA: Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - J A van Dalen
- Department of Medical Physics, Isala Hospital, PO Box 10400, 8000 GK, Zwolle, The Netherlands
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20
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Koenders SS, van Dijk JD, Jager PL, Ottervanger JP, Slump CH, van Dalen JA. How to detect and correct myocardial creep in myocardial perfusion imaging using Rubidium-82 PET? J Nucl Cardiol 2019; 26:729-734. [PMID: 30788759 PMCID: PMC6517341 DOI: 10.1007/s12350-019-01650-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 06/07/2018] [Indexed: 11/24/2022]
Abstract
Reliability of myocardial blood flow (MBF) quantification in myocardial perfusion imaging (MPI) using PET can majorly be affected by the occurrence of myocardial creep when using pharmacologically induced stress. In this paper, we provide instructions on how to detect and correct for myocardial creep. For example, in each time frame of the PET images the myocardium contour and the observed activity have to be compared to check for misalignments. In addition, we provide an overview of the functionality of commonly used software packages to perform this quality control step as not all software packages currently provide this functionality. Furthermore, important clinical considerations to obtain accurate MBF measurements are given.
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Affiliation(s)
- S S Koenders
- Department of Nuclear Medicine, Isala hospital, PO Box 10400, 8000 GK, Zwolle, The Netherlands.
- MIRA: Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
| | - J D van Dijk
- Department of Nuclear Medicine, Isala hospital, PO Box 10400, 8000 GK, Zwolle, The Netherlands
| | - P L Jager
- Department of Nuclear Medicine, Isala hospital, PO Box 10400, 8000 GK, Zwolle, The Netherlands
| | - J P Ottervanger
- Department of Cardiology, Isala hospital, Zwolle, The Netherlands
| | - C H Slump
- MIRA: Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - J A van Dalen
- Department of Medical Physics, Isala hospital, Zwolle, The Netherlands
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21
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Saillant A, Armstrong I, Shah V, Zuehlsdorff S, Hayden C, Declerck J, Saint K, Memmott M, Jenkinson M, Chappell MA. Assessing Reliability of Myocardial Blood Flow After Motion Correction With Dynamic PET Using a Bayesian Framework. IEEE TRANSACTIONS ON MEDICAL IMAGING 2019; 38:1216-1226. [PMID: 30452353 DOI: 10.1109/tmi.2018.2881992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The estimation of myocardial blood flow (MBF) in dynamic PET can be biased by many different processes. A major source of error, particularly in clinical applications, is patient motion. Patient motion, or gross motion, creates displacements between different PET frames as well as between the PET frames and the CT-derived attenuation map, leading to errors in MBF calculation from voxel time series. Motion correction techniques are challenging to evaluate quantitatively and the impact on MBF reliability is not fully understood. Most metrics, such as signal-to-noise ratio (SNR), are characteristic of static images, and are not specific to motion correction in dynamic data. This study presents a new approach of estimating motion correction quality in dynamic cardiac PET imaging. It relies on calculating a MBF surrogate, K1 , along with the uncertainty on the parameter. This technique exploits a Bayesian framework, representing the kinetic parameters as a probability distribution, from which the uncertainty measures can be extracted. If the uncertainty extracted is high, the parameter studied is considered to have high variability - or low confidence - and vice versa. The robustness of the framework is evaluated on simulated time activity curves to ensure that the uncertainties are consistently estimated at the multiple levels of noise. Our framework is applied on 40 patient datasets, divided in 4 motion magnitude categories. Experienced observers manually realigned clinical datasets with 3D translations to correct for motion. K1 uncertainties were compared before and after correction. A reduction of uncertainty after motion correction of up to 60% demonstrates the benefit of motion correction in dynamic PET and as well as provides evidence of the usefulness of the new method presented.
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22
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Abstract
Cardiac PET provides high sensitivity and high negative predictive value in the diagnosis of coronary artery disease and cardiomyopathies. Cardiac, respiratory as well as bulk patient motion have detrimental effects on thoracic PET imaging, in particular on cardiovascular PET imaging where the motion can affect the PET images quantitatively as well as qualitatively. Gating can ameliorate the unfavorable impact of motion additionally enabling evaluation of left ventricular systolic function. In this article, the authors review the recent advances in gating approaches and highlight the advances in data-driven approaches, which hold promise in motion detection without the need for complex hardware setup.
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Affiliation(s)
| | - Jacek Kwiecinski
- Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 90048, USA; British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Piotr J Slomka
- Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 90048, USA.
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23
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AlJaroudi WA, Hage FG. Review of cardiovascular imaging in the Journal of Nuclear Cardiology 2018. Part 1 of 2: Positron emission tomography, computed tomography, and magnetic resonance. J Nucl Cardiol 2019; 26:524-535. [PMID: 30603892 DOI: 10.1007/s12350-018-01558-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 11/28/2018] [Indexed: 12/26/2022]
Abstract
In this review, we summarize key articles that have been published in the Journal of Nuclear Cardiology in 2018 pertaining to nuclear cardiology with advanced multi-modality and hybrid imaging including positron emission tomography, cardiac-computed tomography, and magnetic resonance. In an upcoming review, we will summarize key articles that relate to the progress made in the field of single-photon emission computed tomography. We hope that these sister reviews will be useful to the reader to navigate the literature in our field.
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Affiliation(s)
- Wael A AlJaroudi
- Division of Cardiovascular Medicine, Clemenceau Medical Center, Beirut, Lebanon
| | - Fadi G Hage
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, 306 Lyons-Harrison Research Building, 701 19th Street South, Birmingham, AL, 35294-0007, USA.
- Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA.
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24
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Vleeming EJ, Lazarenko SV, van der Zant FM, Pan XB, Declerck JM, Wondergem M, Knol RJ. Cardiac Displacement During 13N-Ammonia Myocardial Perfusion PET/CT: Comparison Between Adenosine- and Regadenoson-Induced Stress. J Nucl Med Technol 2017; 46:114-122. [DOI: 10.2967/jnmt.117.199463] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 11/28/2017] [Indexed: 11/16/2022] Open
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