scholarly journals Effect of temporal sampling protocols on myocardial blood flow measurements using Rubidium-82 PET

2021 ◽  
Author(s):  
S. S. Koenders ◽  
J. D. van Dijk ◽  
P. L. Jager ◽  
M. Mouden ◽  
A. G. Tegelaar ◽  
...  
Keyword(s):  
Blood Flow ◽  
Myocardial Blood Flow ◽  
Flow Measurements ◽  
Temporal Sampling ◽  
Flow Reserve ◽  
Sampling Protocols ◽  
Blood Flow Measurements ◽  
Time Frames ◽  
Tissue Phase ◽  
Rubidium 82

Abstract Background A variety of temporal sampling protocols is used worldwide to measure myocardial blood flow (MBF). Both the length and number of time frames in these protocols may alter MBF and myocardial flow reserve (MFR) measurements. We aimed to assess the effect of different clinically used temporal sampling protocols on MBF and MFR quantification in Rubidium-82 (Rb-82) PET imaging. Methods We retrospectively included 20 patients referred for myocardial perfusion imaging using Rb-82 PET. A literature search was performed to identify appropriate sampling protocols. PET data were reconstructed using 14 selected temporal sampling protocols with time frames of 5-10 seconds in the first-pass phase and 30-120 seconds in the tissue phase. Rest and stress MBF and MFR were calculated for all protocols and compared to the reference protocol with 26 time frames. Results MBF measurements differed (P ≤ 0.003) in six (43%) protocols in comparison to the reference protocol, with mean absolute relative differences up to 16% (range 5%-31%). Statistically significant differences were most frequently found for protocols with tissue phase time frames < 90 seconds. MFR did not differ (P ≥ 0.11) for any of the protocols. Conclusions Various temporal sampling protocols result in different MBF values using Rb-82 PET. MFR measurements were more robust to different temporal sampling protocols.

scholarly journals Optimally Repeatable Kinetic Model Variant for Myocardial Blood Flow Measurements with 82Rb PET

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Adrian F. Ocneanu ◽  
Robert A. deKemp ◽  
Jennifer M. Renaud ◽  
Andy Adler ◽  
Rob S. B. Beanlands ◽  
...  
Keyword(s):  
Blood Flow ◽  
Kinetic Model ◽  
Myocardial Blood Flow ◽  
Input Function ◽  
Blood Pool ◽  
Flow Measurements ◽  
Flow Reserve ◽  
Arterial Blood ◽  
Spillover Correction ◽  
Blood Flow Measurements

Purpose. Myocardial blood flow (MBF) quantification with Rb82 positron emission tomography (PET) is gaining clinical adoption, but improvements in precision are desired. This study aims to identify analysis variants producing the most repeatable MBF measures. Methods. 12 volunteers underwent same-day test-retest rest and dipyridamole stress imaging with dynamic Rb82 PET, from which MBF was quantified using 1-tissue-compartment kinetic model variants: (1) blood-pool versus uptake region sampled input function (Blood/Uptake-ROI), (2) dual spillover correction (SOC-On/Off), (3) right blood correction (RBC-On/Off), (4) arterial blood transit delay (Delay-On/Off), and (5) distribution volume (DV) constraint (Global/Regional-DV). Repeatability of MBF, stress/rest myocardial flow reserve (MFR), and stress/rest MBF difference (ΔMBF) was assessed using nonparametric reproducibility coefficients (RPCnp = 1.45 × interquartile range). Results. MBF using SOC-On, RVBC-Off, Blood-ROI, Global-DV, and Delay-Off was most repeatable for combined rest and stress: RPCnp = 0.21 mL/min/g (15.8%). Corresponding MFR and ΔMBF RPCnp were 0.42 (20.2%) and 0.24 mL/min/g (23.5%). MBF repeatability improved with SOC-On at stress (p<0.001) and tended to improve with RBC-Off at both rest and stress (p<0.08). DV and ROI did not significantly influence repeatability. The Delay-On model was overdetermined and did not reliably converge. Conclusion. MBF and MFR test-retest repeatability were the best with dual spillover correction, left atrium blood input function, and global DV.

The impact of prompt gamma compensation on myocardial blood flow measurements with rubidium-82 dynamic PET

2016 ◽  
Vol 25 (2) ◽  
pp. 596-605 ◽  
Author(s):  
Ian S. Armstrong ◽  
Matthew J. Memmott ◽  
Christine M. Tonge ◽  
Parthiban Arumugam
Keyword(s):  
Blood Flow ◽  
Myocardial Blood Flow ◽  
Prompt Gamma ◽  
Dynamic Pet ◽  
Flow Measurements ◽  
Blood Flow Measurements ◽  
The Impact ◽  
Rubidium 82

scholarly journals Entropy-based myocardial blood flow measurements using PET: a way to improve reproducibility

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
J Van Dalen ◽  
SS Koenders ◽  
BN Vendel ◽  
PL Jager ◽  
JD Van Dijk
Keyword(s):  
Blood Flow ◽  
Myocardial Blood Flow ◽  
Flow Parameter ◽  
Myocardial Flow Reserve ◽  
Flow Measurements ◽  
Shannon's Entropy ◽  
Flow Reserve ◽  
The Mean ◽  
Myocardial Flow ◽  
Rubidium 82

Abstract Funding Acknowledgements Type of funding sources: None. Background and purpose Myocardial blood flow (MBF) measurements using PET are increasingly used to guide the management of patients with (suspected) coronary artery disease (CAD). Day-to-day variability of these measurements is poor with a 21% standard deviation or 40% 95%-confidence interval [Reference: JACC Cardiovasc Imaging, 2017;10(5):565]. This limits clinical applicability in diagnosis, risk stratification and follow-up as these all depend on comparison of flow values with fixed cut-off values. We expect that reproducibility can be improved by combining flow measurements with the variation of flow values within the myocardium. As entropy is a measure of variability of the associated distribution, we compared the reproducibility of an entropy-based flow parameter with that of conventional myocardial flow reserve (MFR) measurements. Methods We performed a study using intra-individual comparison in 24 patients who underwent rest and regadenoson-induced stress myocardial perfusion imaging using Rubidium-82 on two different PET systems (PET1: Discovery 690, GE Healthcare, and PET2: Vereos, Philips Healthcare) within 3 weeks. MBF for both rest and stress was calculated using Lortie’s one-tissue compartment model (Corridor4DM, INVIA). MFR (ratio of MBF stress/rest) was determined for the myocardial as a whole (MFRglobal), for the three vascular territories: LAD, LCX and RCA (MFRregional) and for the 17 segments. Next, we calculated Shannon’s entropy to measure the variation of the 17 MFR segmental values. We multiplied Shannon’s entropy by the mean of the MFR segmental values resulting in an entropy-based MFR (MFRentropy). For each patient MFRglobal, MFRregional and MRFentropy were compared between both PET systems. For each of the three parameters the test-retest precision was calculated as the SD of the relative difference between measurements. Results The mean difference in MFR measurements between both cameras did not differ from zero (p &gt; 0.05). Mean values for PET1 were MFRglobal = 2.4, MFRregional = 2.4 (LAD), 2.4 (LCX) and 2.5 (RCA), and MFRentropy = 2.4. For PET2 we found MFRglobal = 2.5, MFRregional = 2.5 (LAD), 2.4 (LCX) and 2.6 (RCA), and MFRentropy = 2.5. Test-retest precision was lower for MFRentropy with 11% compared to that of MFRglobal (21%), MFRregional LAD (22%), MFRregional LCX (23%) and MFRregional RCA (24%) (p &lt; 0.01). Conclusion The reproducibility of myocardial flow reserve measurements using Rubidium-82 PET improved by a factor of 2 when an entropy-based flow parameter instead of global or regional MFR parameters is used. This entropy-based flow-parameter may be used to better discriminate ischemia from non-ischemia and may therefore improve CAD management.

scholarly journals Low CT temporal sampling rates result in a substantial underestimation of myocardial blood flow measurements

2018 ◽  
Vol 35 (3) ◽  
pp. 539-547 ◽  
Author(s):  
Marly van Assen ◽  
Gert Jan Pelgrim ◽  
Emmy Slager ◽  
Sjoerd van Tuijl ◽  
U. Joseph Schoepf ◽  
...  
Keyword(s):  
Blood Flow ◽  
Myocardial Blood Flow ◽  
Flow Measurements ◽  
Temporal Sampling ◽  
Blood Flow Measurements

Short-term repeatability of resting myocardial blood flow measurements using rubidium-82 PET imaging

2012 ◽  
Vol 19 (5) ◽  
pp. 997-1006 ◽  
Author(s):  
Matthew Efseaff ◽  
Ran Klein ◽  
Maria C. Ziadi ◽  
Rob S. Beanlands ◽  
Robert A. deKemp
Keyword(s):  
Blood Flow ◽  
Myocardial Blood Flow ◽  
Pet Imaging ◽  
Short Term ◽  
Flow Measurements ◽  
Blood Flow Measurements ◽  
Rubidium 82

Image-Based Measurements of Myocardial Blood Flow

2015 ◽  
Author(s):  
Heinrich R. Schelbert
Keyword(s):  
Blood Flow ◽  
Myocardial Blood Flow ◽  
Structural Changes ◽  
Large Body ◽  
Treatment Strategies ◽  
Flow Measurements ◽  
Time Activity ◽  
Flow Reserve ◽  
Coronary Stenoses ◽  
Functional Consequences

Image-based measurements of myocardial blood flow afford the assessment of coronary circulatory function. They reflect functional consequences of coronary stenoses, diffuse epicardial vessel disease and microvascular dysfunction and structural changes and thus provide a measure of the total ischemic burden. Measured flows contain therefore clinically important predictive information. Fundamental to flow measurements are the tissue tracer kinetics, their description through tracer kinetic models, high spatial and temporal resolution imaging devices and accurate extraction of radiotracer tissue concentrations from dynamically acquired images for estimating true flows from the tissue time activity curves. A large body of literature on measurements of myocardial blood flow exists for defining in humans normal values for flow at baseline and during hyperemic stress as well as for the myocardial flow reserve. The role of PET for flow measurements has been well established; initial results with modern SPECT devices are encouraging. Responses of myocardial blood flow to specific challenges like pharmacologic vasodilation and to sympathetic stimulation can uncover functional consequences of focal epicardial coronary stenoses, of conduit vessel disturbances and disease and impairments of microvascular function. Apart from risk stratification, flow measurements may allow detection of early preclinical disease, influence treatment strategies and identify therapy responses.

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