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Kawakubo M, Nagao M, Yamamoto A, Kaimoto Y, Nakao R, Kawasaki H, Iwaguchi T, Inoue A, Kaneko K, Sakai A, Sakai S. Gated SPECT-Derived Myocardial Strain Estimated From Deep-Learning Image Translation Validated From N-13 Ammonia PET. Acad Radiol 2024:S1076-6332(24)00433-1. [PMID: 39095261 DOI: 10.1016/j.acra.2024.06.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/24/2024] [Accepted: 06/27/2024] [Indexed: 08/04/2024]
Abstract
RATIONALE AND OBJECTIVES This study investigated the use of deep learning-generated virtual positron emission tomography (PET)-like gated single-photon emission tomography (SPECTVP) for assessing myocardial strain, overcoming limitations of conventional SPECT. MATERIALS AND METHODS SPECT-to-PET translation models for short-axis, horizontal, and vertical long-axis planes were trained using image pairs from the same patients in stress (720 image pairs from 18 patients) and resting states (920 image pairs from 23 patients). Patients without ejection-fraction changes during SPECT and PET were selected for training. We independently analyzed circumferential strains from short-axis-gated SPECT, PET, and model-generated SPECTVP images using a feature-tracking algorithm. Longitudinal strains were similarly measured from horizontal and vertical long-axis images. Intraclass correlation coefficients (ICCs) were calculated with two-way random single-measure SPECT and SPECTVP (PET). ICCs (95% confidence intervals) were defined as excellent (≥0.75), good (0.60-0.74), moderate (0.40-0.59), or poor (≤0.39). RESULTS Moderate ICCs were observed for SPECT-derived stressed circumferential strains (0.56 [0.41-0.69]). Excellent ICCs were observed for SPECTVP-derived stressed circumferential strains (0.78 [0.68-0.85]). Excellent ICCs of stressed longitudinal strains from horizontal and vertical long axes, derived from SPECT and SPECTVP, were observed (0.83 [0.73-0.90], 0.91 [0.85-0.94]). CONCLUSION Deep-learning SPECT-to-PET transformation improves circumferential strain measurement accuracy using standard-gated SPECT. Furthermore, the possibility of applying longitudinal strain measurements via both PET and SPECTVP was demonstrated. This study provides preliminary evidence that SPECTVP obtained from standard-gated SPECT with postprocessing potentially adds clinical value through PET-equivalent myocardial strain analysis without increasing the patient burden.
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Affiliation(s)
- Masateru Kawakubo
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Michinobu Nagao
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan.
| | - Atsushi Yamamoto
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Yoko Kaimoto
- Department of Radiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Risako Nakao
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Hiroshi Kawasaki
- Department of Advanced Information Technology, Faculty of Information Science and Electrical Engineering, Kyushu University, Fukuoka, Japan
| | - Takafumi Iwaguchi
- Department of Advanced Information Technology, Faculty of Information Science and Electrical Engineering, Kyushu University, Fukuoka, Japan
| | - Akihiro Inoue
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Koichiro Kaneko
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Akiko Sakai
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Shuji Sakai
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan
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Yamamoto A, Nagao M, Kawakubo M, Nakao R, Matsuo Y, Sakai A, Kaneko K, Fukushima K, Momose M, Sakai S, Yamaguchi J. Risk Stratification Using Right Ventricular Longitudinal Strain Ratio Derived from 13N-Ammonia PET in Patients with Ischemic Heart Disease. Radiol Cardiothorac Imaging 2024; 6:e230298. [PMID: 38814185 PMCID: PMC11211937 DOI: 10.1148/ryct.230298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 03/18/2024] [Accepted: 04/15/2024] [Indexed: 05/31/2024]
Abstract
Purpose To investigate whether right ventricular (RV) myocardial strain ratio (RVMSR) assessed using nitrogen 13 ammonia (13N-NH3) PET can predict cardiovascular events in patients with ischemic heart disease (IHD). Materials and Methods This retrospective study included 480 consecutive patients (mean age, 66 years ± 12 [SD]; 334 males and 146 females) with IHD who underwent 13N-NH3 PET. RVMSR was defined as the ratio of RV strain during stress to that at rest. The primary end point was major adverse cardiac events (MACEs), defined as cardiac death or heart failure hospitalization. The ability of RVMSR to predict MACE was assessed using receiver operating characteristic (ROC) curve and Kaplan-Meier analyses. Cox proportional hazards regression analysis was used to calculate hazard ratios (HRs) with 95% CIs. Results ROC curve analysis identified a sensitivity and specificity of 84% and 82%, respectively, for predicting MACE from RVMSR. Patients with reduced RVMSR (<110.2) displayed a significantly higher rate of MACE than those with a preserved RVMSR (34 of 240 vs four of 240; P < .001). Cox proportional hazards regression analysis of imaging parameters, including myocardial flow reserve, indicated that RVMSR was an independent predictor of MACE (HR, 0.94 [95% CI: 0.92, 0.97]; P < .001). Conclusion RVMSR was an independent predictor of MACE and has potential to aid in the risk stratification of patients with IHD. Keywords: Right Ventricular Myocardial Strain Ratio, Myocardial Flow Reserve, Ischemic Heart Disease, 13N-Ammonia Positron Emission Tomography Supplemental material is available for this article. © RSNA, 2024.
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Affiliation(s)
- Atsushi Yamamoto
- From the Department of Cardiology (A.Y., R.N., A.S., J.Y.) and
Department of Diagnostic Imaging and Nuclear Medicine (A.Y., M.N., Y.M., K.K.,
M.M., S.S.), Tokyo Women's Medical University, 8-1 Kawada-cho,
Shinjuku-ku, Tokyo, Japan 162-8666; Department of Health Sciences, Faculty of
Medical Sciences, Kyushu University, Fukuoka, Japan (M.K.); and Department of
Radiology and Nuclear Medicine, Fukushima Medical University, Fukushima, Japan
(K.F.)
| | - Michinobu Nagao
- From the Department of Cardiology (A.Y., R.N., A.S., J.Y.) and
Department of Diagnostic Imaging and Nuclear Medicine (A.Y., M.N., Y.M., K.K.,
M.M., S.S.), Tokyo Women's Medical University, 8-1 Kawada-cho,
Shinjuku-ku, Tokyo, Japan 162-8666; Department of Health Sciences, Faculty of
Medical Sciences, Kyushu University, Fukuoka, Japan (M.K.); and Department of
Radiology and Nuclear Medicine, Fukushima Medical University, Fukushima, Japan
(K.F.)
| | - Masateru Kawakubo
- From the Department of Cardiology (A.Y., R.N., A.S., J.Y.) and
Department of Diagnostic Imaging and Nuclear Medicine (A.Y., M.N., Y.M., K.K.,
M.M., S.S.), Tokyo Women's Medical University, 8-1 Kawada-cho,
Shinjuku-ku, Tokyo, Japan 162-8666; Department of Health Sciences, Faculty of
Medical Sciences, Kyushu University, Fukuoka, Japan (M.K.); and Department of
Radiology and Nuclear Medicine, Fukushima Medical University, Fukushima, Japan
(K.F.)
| | - Risako Nakao
- From the Department of Cardiology (A.Y., R.N., A.S., J.Y.) and
Department of Diagnostic Imaging and Nuclear Medicine (A.Y., M.N., Y.M., K.K.,
M.M., S.S.), Tokyo Women's Medical University, 8-1 Kawada-cho,
Shinjuku-ku, Tokyo, Japan 162-8666; Department of Health Sciences, Faculty of
Medical Sciences, Kyushu University, Fukuoka, Japan (M.K.); and Department of
Radiology and Nuclear Medicine, Fukushima Medical University, Fukushima, Japan
(K.F.)
| | - Yuka Matsuo
- From the Department of Cardiology (A.Y., R.N., A.S., J.Y.) and
Department of Diagnostic Imaging and Nuclear Medicine (A.Y., M.N., Y.M., K.K.,
M.M., S.S.), Tokyo Women's Medical University, 8-1 Kawada-cho,
Shinjuku-ku, Tokyo, Japan 162-8666; Department of Health Sciences, Faculty of
Medical Sciences, Kyushu University, Fukuoka, Japan (M.K.); and Department of
Radiology and Nuclear Medicine, Fukushima Medical University, Fukushima, Japan
(K.F.)
| | - Akiko Sakai
- From the Department of Cardiology (A.Y., R.N., A.S., J.Y.) and
Department of Diagnostic Imaging and Nuclear Medicine (A.Y., M.N., Y.M., K.K.,
M.M., S.S.), Tokyo Women's Medical University, 8-1 Kawada-cho,
Shinjuku-ku, Tokyo, Japan 162-8666; Department of Health Sciences, Faculty of
Medical Sciences, Kyushu University, Fukuoka, Japan (M.K.); and Department of
Radiology and Nuclear Medicine, Fukushima Medical University, Fukushima, Japan
(K.F.)
| | - Koichiro Kaneko
- From the Department of Cardiology (A.Y., R.N., A.S., J.Y.) and
Department of Diagnostic Imaging and Nuclear Medicine (A.Y., M.N., Y.M., K.K.,
M.M., S.S.), Tokyo Women's Medical University, 8-1 Kawada-cho,
Shinjuku-ku, Tokyo, Japan 162-8666; Department of Health Sciences, Faculty of
Medical Sciences, Kyushu University, Fukuoka, Japan (M.K.); and Department of
Radiology and Nuclear Medicine, Fukushima Medical University, Fukushima, Japan
(K.F.)
| | - Kenji Fukushima
- From the Department of Cardiology (A.Y., R.N., A.S., J.Y.) and
Department of Diagnostic Imaging and Nuclear Medicine (A.Y., M.N., Y.M., K.K.,
M.M., S.S.), Tokyo Women's Medical University, 8-1 Kawada-cho,
Shinjuku-ku, Tokyo, Japan 162-8666; Department of Health Sciences, Faculty of
Medical Sciences, Kyushu University, Fukuoka, Japan (M.K.); and Department of
Radiology and Nuclear Medicine, Fukushima Medical University, Fukushima, Japan
(K.F.)
| | - Mitsuru Momose
- From the Department of Cardiology (A.Y., R.N., A.S., J.Y.) and
Department of Diagnostic Imaging and Nuclear Medicine (A.Y., M.N., Y.M., K.K.,
M.M., S.S.), Tokyo Women's Medical University, 8-1 Kawada-cho,
Shinjuku-ku, Tokyo, Japan 162-8666; Department of Health Sciences, Faculty of
Medical Sciences, Kyushu University, Fukuoka, Japan (M.K.); and Department of
Radiology and Nuclear Medicine, Fukushima Medical University, Fukushima, Japan
(K.F.)
| | - Shuji Sakai
- From the Department of Cardiology (A.Y., R.N., A.S., J.Y.) and
Department of Diagnostic Imaging and Nuclear Medicine (A.Y., M.N., Y.M., K.K.,
M.M., S.S.), Tokyo Women's Medical University, 8-1 Kawada-cho,
Shinjuku-ku, Tokyo, Japan 162-8666; Department of Health Sciences, Faculty of
Medical Sciences, Kyushu University, Fukuoka, Japan (M.K.); and Department of
Radiology and Nuclear Medicine, Fukushima Medical University, Fukushima, Japan
(K.F.)
| | - Junichi Yamaguchi
- From the Department of Cardiology (A.Y., R.N., A.S., J.Y.) and
Department of Diagnostic Imaging and Nuclear Medicine (A.Y., M.N., Y.M., K.K.,
M.M., S.S.), Tokyo Women's Medical University, 8-1 Kawada-cho,
Shinjuku-ku, Tokyo, Japan 162-8666; Department of Health Sciences, Faculty of
Medical Sciences, Kyushu University, Fukuoka, Japan (M.K.); and Department of
Radiology and Nuclear Medicine, Fukushima Medical University, Fukushima, Japan
(K.F.)
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Romero-Farina G, Aguadé-Bruix S. Current vision of a disease with high mortality that is progressively dispersing throughout the world: Chagasic heart disease. J Nucl Cardiol 2023; 30:2389-2399. [PMID: 37280386 DOI: 10.1007/s12350-023-03301-8] [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: 05/08/2023] [Accepted: 05/08/2023] [Indexed: 06/08/2023]
Abstract
The sympathetic denervation studies and the studies of microvascular involvement are the most important tools for early detection of Chagas heart disease. Especially the 123I-123I-MIBGSPECT or 11C-meta-hydroxyephedrine-PET studies since everything starts from sympathetic denervation. Also it is advisable to insist on the assessment of other parameters of early involvement of left ventricular systolic function to understand the importance of the additional information provided by the analysis of the parameters of ventricular remodeling, synchrony, and GLS in patients with normal left ventricular ejection fraction and in the absence of ventricular dilatation for early detection of myocardial dysfunction.
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Affiliation(s)
- Guillermo Romero-Farina
- Nuclear Cardiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.
- Centro de investigación biomédica en red: enfermedades cardiovasculares (CIBER-CV), Madrid, Spain.
- Grup d'imatge mèdica molecular (GRIMM), Barcelona, Spain.
- Cardiology Department, Consorci Sanitari de l'Alt Penedès i Garraf (CSAPG), Barcelona, Spain.
- Cardiology Department, Valld'Hebron University Hospital, Valld'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.
- Nuclear Medicine Department and Cardiology Department, Hospital, UniversitariValld'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain.
| | - Santiago Aguadé-Bruix
- Nuclear Cardiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de investigación biomédica en red: enfermedades cardiovasculares (CIBER-CV), Madrid, Spain
- Grup d'imatge mèdica molecular (GRIMM), Barcelona, Spain
- Nuclear Medicine Department and Cardiology Department, Hospital, UniversitariValld'Hebron, Paseo Vall d'Hebron 119-129, 08035, Barcelona, Spain
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Nagao M, Kawakubo M, Yamamoto A, Nakao R, Matsuo Y, Fukushima K, Sakai A, Momose M, Sakai S. Myocardial Strain Derived from 13N-ammonia Positron Emission Tomography: Detection of Ischemia-Related Wall Motion Abnormality. ANNALS OF NUCLEAR CARDIOLOGY 2023; 9:26-32. [PMID: 38058577 PMCID: PMC10696145 DOI: 10.17996/anc.22-00161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 10/05/2022] [Accepted: 10/17/2022] [Indexed: 12/08/2023]
Abstract
Background: Due to the limitation of spatial resolution, cardiac nuclear medicine images have not been applied to feature-tracking method to automatic extraction of myocardial contours. We have successfully applied the feature-tracking method to high-resolution cine 13N-ammonia positron emission tomography (PET) images to calculate the regional myocardial strains. Here, we investigate the potential of 13N-ammonia PET-derived strain to detect ischemia-related wall motion abnormality. Methods: Data of adenosine-stress/rest 13N-ammonia PET for 95 coronary artery disease patients was retrospectively analyzed. Using an original algorithm dedicated to 13N-ammonia PET, the longitudinal strain (LS) corresponding to the three main coronary artery territories [right coronary artery (RCA), left anterior descending artery (LAD), and left circumflex coronary artery (LCX)] was calculated from semi-automatic endocardial contours extraction on cine 13N-ammonia PET images of the left ventricular long-axis. The presence of ischemia in three main territories was determined from rest and stress-perfusion images. Results: In all three coronary territories, LS at stress was significantly smaller at rest in the ischemic region RCA: -19.2±8.0% vs. -22.7±6.1%, LAD: -19.0±6.9% vs. -24.4±6.4%, LCX: -20.5%±7.6% vs. -22.6±6.9%). In contrast, in the non-ischemic region, there was no significant difference between the LS at stress and at rest. Receiver-operating-characteristic analysis revealed that using the optimal cutoff of the LS ratio of stress to rest, ischemia could be diagnosed with area under the curve of 0.82 in the RCA, 0.86 in the LAD, and 0.69 in the LCX. Conclusions: Myocardial strain derived from endocardial feature-tracking of 13N-ammonia PET cine imaging is reduced in the ischemia induced by adenosine-stress. The LS ratio of stress to rest may detect wall motion abnormality related to ischemia.
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Affiliation(s)
- Michinobu Nagao
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Masateru Kawakubo
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Atsushi Yamamoto
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Risako Nakao
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yuka Matsuo
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Kenji Fukushima
- Department of Nuclear Medicine, Fukushima Medical University, Fukushima, Japan
| | - Akiko Sakai
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Mitsuru Momose
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Shuji Sakai
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
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Huang J, Mitchell AJ, Garcia EV, Cooke CD, Folks R, Pernetz M, Goyal A, Piccinelli M, Nye JA. Left Ventricular Strain from Myocardial Perfusion PET Imaging: Method Development and Comparison to 2-Dimensional Echocardiography. J Nucl Med 2023; 64:932-939. [PMID: 36522185 PMCID: PMC10241013 DOI: 10.2967/jnumed.122.264516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 12/12/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
This study aimed to develop a measure of longitudinal, radial, and circumferential myocardial strain at rest and regadenoson during pharmacologic stress using 82Rb PET electrocardiography-gated myocardial perfusion imaging (MPI). Methods: We retrospectively identified 80 patients who underwent rest and regadenoson-stress CT attenuation-corrected 82Rb PET and had a standard resting transthoracic echocardiogram (TTE) with global longitudinal strain (GLS) analysis within 3 mo. A method was developed to compute longitudinal, radial, and circumferential strain from PET MPI at stress and rest. PET MPI-derived strain and left ventricular function were compared with resting TTE measures as the clinical reference standard. Interobserver agreement of PET MPI strain and left ventricular ejection fraction processing was reported. Results: Longitudinal strain assessed with resting TTE GLS showed good correlation with PET MPI at stress (r = 0.68, P < 0.001) and rest (r = 0.58, P < 0.001). Resting TTE GLS also correlated with PET MPI radial strain at stress (r = -0.70, P < 0.001) and rest (r = -0.59, P < 0.001) and circumferential strain at stress (r = 0.67, P < 0.001) and rest (r = 0.69, P < 0.001). The left ventricular ejection fraction showed good correlation between resting TTE and PET MPI at stress (r = 0.83, P < 0.001) and rest (r = 0.80, P < 0.001). Bland-Altman analysis indicated positive bias of TTE GLS compared with PET MPI longitudinal strain at stress (mean difference = 5.1%, 95% CI = [-2.5, 12.7]) and rest (mean difference = 4.2%, 95% CI = [-4.3, 12.8]). Reproducibility of PET MPI longitudinal strain showed good agreement at stress (concordance correlation coefficient = 0.73, P < 0.001) and rest (concordance correlation coefficient = 0.74, P < 0.001), with Bland-Altman analysis showing a small bias in the longitudinal direction at stress (mean difference = -0.2%) and rest (mean difference = -1.0%). Conclusion: Strain measured with PET MPI using an automated technique correlated well with resting GLS strain obtained by TTE, and the measure is reproducible. Strain from PET MPI should be investigated further to establish reference ranges and assess its value in routine clinical practice.
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Affiliation(s)
- Jingwen Huang
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Adam J Mitchell
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia;
| | - Ernest V Garcia
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia; and
| | - C David Cooke
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia; and
| | - Russell Folks
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia; and
| | - Maria Pernetz
- Emory Adult Congenital Heart Center, Emory University School of Medicine, Atlanta, Georgia
| | - Abhinav Goyal
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia
| | - Marina Piccinelli
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia; and
| | - Jonathon A Nye
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia; and
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Prediction of cardiovascular events using myocardial strain ratio derived from 13N-ammonia positron emission tomography. Eur Radiol 2022; 33:3889-3896. [PMID: 36562782 DOI: 10.1007/s00330-022-09359-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 09/23/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Myocardial flow reserve (MFR), derived from ammonia N-13 positron emission tomography (NH3-PET), can predict the prognosis of patients with various heart diseases. We aimed to investigate whether myocardial strain ratio (MSR) was useful in predicting MACE and allowed for further risk stratification of cardiovascular events in patients with ischemic heart disease (IHD) in addition to MFR. METHODS Ninety-five patients underwent NH3-PET because of IHD. MFR was determined as the ratio of hyperemic to resting myocardial blood flow (MBF). MSR was defined as the ratio of strains at stress and rest. The endpoint was major adverse cardiac events (MACE), including all-cause death, acute coronary syndrome, heart failure hospitalization, and revascularization. The ability to predict MACE was assessed using receiver operating characteristic (ROC) analysis, and the predictability of ME was analyzed using Kaplan-Meier analysis. The Cox proportional hazards regression model was used to calculate the hazard ratio (HR) with 95% confidence interval (CI). RESULTS The ROC curve analysis demonstrated a cutoff of 0.93 for MACE with MSR (sensitivity and specificity of 77% and 71%, respectively). Patients with MSR < 0.93 displayed a significantly higher MACE rate than those with MSR ≥ 0.93 (p = 0.0036). The Cox proportional hazards regression analysis indicated that MSR was an independent marker that could predict MACE in imaging and clinical parameters (HR, 7.32; 95% CI: 1.59-33.7, p = 0.011). CONCLUSIONS MSR was an independent predictor of MACE and was useful for further risk stratification in IHD. MSR has the potential for a new indicator of revascularization in patients with IHD. KEY POINTS • We hypothesized that combining myocardial flow reserve (MFR) with the myocardial strain ratio (MSR) obtained by applying the feature-tracking technique to ammonia N-13 PET would make it predictive of major adverse cardiac events (MACE) compared to MFR alone. • MSR was an independent predictor of MACE, allowing for further risk stratification in addition to MFR in patients with ischemic heart disease. • MSR is a potential new indicator of revascularization.
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Kawakubo M, Nagao M, Kikuchi N, Yamamoto A, Nakao R, Matsuo Y, Kaneko K, Watanabe E, Sasaki M, Nunoda S, Sakai S. 13N-ammonia positron emission tomography-derived left-ventricular strain in patients after heart transplantation validated using cardiovascular magnetic resonance feature tracking as reference. Ann Nucl Med 2022; 36:70-81. [PMID: 34643890 DOI: 10.1007/s12149-021-01686-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/06/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Heart transplant rejection leads to cardiac allograft vasculopathy (CAV). 13N-ammonia positron emission tomography (PET) can be useful in detecting CAV, as it can evaluate both epicardial vessels and microvasculature. In this study, we evaluated the regional wall motion in heart transplant patients using our PET-specific feature-tracking (FT) algorithm for myocardial strain calculation and validated it using a cardiovascular magnetic resonance (CMR) FT strain as a reference. METHODS A total of 15 heart transplant patients who underwent both 13N-ammonia PET and CMR within 3 months were retrospectively enrolled. The same slice position of short-axis cine images of the middle slice of left ventricle (LV) and the same slice position of horizontal long-axis cine images were selected for the two modalities to measure the circumferential strain (CS) and longitudinal strain (LS), respectively. Based on the FT technique, time-strain curves were calculated by semi-automatic tracking of the endocardial contour on cine images throughout a cardiac cycle. The peak value in the time-strain curve was defined as the representative value. Correlations of CS and LS between PET and CMR were analyzed using Pearson correlation coefficients. The inter-modality error of strain measurements was evaluated using intraclass correlation coefficients (ICCs) with two-way random single measures. RESULTS Excellent correlations of CS and LS between PET and CMR were observed (CS: r = 0.80; p < 0.01; LS: r = 0.87; p < 0.01). Excellent ICCs were observed (0.89 and 0.85) in CS and LS derived from PET. CONCLUSIONS We propose the first PET strain showing an excellent agreement with the CMR strain and high reproducibility in measurement.
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Affiliation(s)
- Masateru Kawakubo
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Michinobu Nagao
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
| | - Noriko Kikuchi
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Atsushi Yamamoto
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Risako Nakao
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yuka Matsuo
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Koichiro Kaneko
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Eri Watanabe
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Masayuki Sasaki
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shinichi Nunoda
- Department of Therapeutic Strategy for Severe Heart Failure, Graduate School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Shuji Sakai
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
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Kawakubo M, Nagao M, Yamamoto A, Nakao R, Matsuo Y, Kaneko K, Watanabe E, Sakai A, Sasaki M, Sakai S. 13 N-ammonia PET-derived right ventricular longitudinal strain and myocardial flow reserve in right coronary artery disease. Eur J Nucl Med Mol Imaging 2021; 49:1870-1880. [PMID: 34897553 DOI: 10.1007/s00259-021-05647-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 12/03/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE We developed a feature-tracking algorithm for use with electrocardiography-gated high-resolution 13 N-ammonia positron emission tomography (PET) imaging, and we hypothesized it could be used to clarify the association between right ventricular (RV) longitudinal strain (LS) and right coronary artery (RCA) ischemia. The aim of this study was to investigate the association between the reduction of regional myocardial flow reserve (MFR) in RCA territories and PET-derived LS of the RV free wall. METHODS Ninety-three patients with coronary artery stenosis > 50%, diagnosed by coronary computed tomography angiography, and 10 controls were retrospectively analyzed. RV-LS in the free wall was measured by a feature-tracking technique on the resting and stressed 13 N-ammonia PET images of horizontal long axis slices. The patients were sub-grouped according to regional MFR values at the territories of RCA, left anterior descending artery (LAD), and left circumflex coronary artery (LCx): RCA-MFR < 2.0 [n = 34], RCA-MFR ≥ 2.0 but MFR < 2.0 at LAD or LCx territories [n = 11], and MFR ≥ 2.0 for all territories [n = 48]. Stress and resting RV-LS were compared in each of the four groups. Multiple comparisons of RV-LS among the four groups were performed in the stress and resting state. RESULTS Decreased stress RV-LS in patients with an RCA-MFR < 2.0 was observed. In the patients with MFR ≥ 2.0 for all territories, the stressed RV-LS was significantly increased compared to that in the resting state. Significantly decreased RV free wall LS during adenosine stress in patients with RCA-MFR < 2.0 was observed in the other three groups. CONCLUSIONS We measured RV myocardial LS using feature tracking in cine imaging of 13 N-ammonia PET. The results of this study suggest that PET-derived stressed RV-LS is useful for detecting reduced RV myocardial motion due to ischemia in the RCA territory.
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Affiliation(s)
- Masateru Kawakubo
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Michinobu Nagao
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
| | - Atsushi Yamamoto
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Risako Nakao
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yuka Matsuo
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Koichiro Kaneko
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Eri Watanabe
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Akiko Sakai
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Masayuki Sasaki
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shuji Sakai
- Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
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Campisi R, Merani MF, Rodríguez MI. BMIPP SPECT in cardiac sarcoidosis: A marker of risk? J Nucl Cardiol 2021; 28:930-935. [PMID: 33904149 DOI: 10.1007/s12350-021-02626-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 03/31/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Roxana Campisi
- Departments of Nuclear Medicine and Cardiovascular Imaging, Diagnóstico Maipú, Diagnóstico Maipú, Av. Maipú 1668, Vicente López (B1602ABQ), Buenos Aires, Argentina.
- Department of Nuclear Medicine, Instituto Argentino de Diagnóstico y Tratamiento S.A, Buenos Aires, Argentina.
| | - María Fernanda Merani
- Departments of Nuclear Medicine and Cardiovascular Imaging, Diagnóstico Maipú, Diagnóstico Maipú, Av. Maipú 1668, Vicente López (B1602ABQ), Buenos Aires, Argentina
- Department of Nuclear Medicine, Instituto Argentino de Diagnóstico y Tratamiento S.A, Buenos Aires, Argentina
| | - Marina I Rodríguez
- Departments of Nuclear Medicine and Cardiovascular Imaging, Diagnóstico Maipú, Diagnóstico Maipú, Av. Maipú 1668, Vicente López (B1602ABQ), Buenos Aires, Argentina
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