Dunet Vincent, Klein Ran, Allenbach Gilles, Renaud Jennifer, deKemp Robert A, Prior John O
Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
University of Ottawa Heart Institute, Cardiac PET Centre, Ottawa, Canada.
J Nucl Cardiol. 2016 Jun;23(3):499-510. doi: 10.1007/s12350-015-0151-2. Epub 2015 May 21.
Several analysis software packages for myocardial blood flow (MBF) quantification from cardiac PET studies exist, but they have not been compared using concordance analysis, which can characterize precision and bias separately. Reproducible measurements are needed for quantification to fully develop its clinical potential.
Fifty-one patients underwent dynamic Rb-82 PET at rest and during adenosine stress. Data were processed with PMOD and FlowQuant (Lortie model). MBF and myocardial flow reserve (MFR) polar maps were quantified and analyzed using a 17-segment model. Comparisons used Pearson's correlation ρ (measuring precision), Bland and Altman limit-of-agreement and Lin's concordance correlation ρc = ρ·C b (C b measuring systematic bias).
Lin's concordance and Pearson's correlation values were very similar, suggesting no systematic bias between software packages with an excellent precision ρ for MBF (ρ = 0.97, ρc = 0.96, C b = 0.99) and good precision for MFR (ρ = 0.83, ρc = 0.76, C b = 0.92). On a per-segment basis, no mean bias was observed on Bland-Altman plots, although PMOD provided slightly higher values than FlowQuant at higher MBF and MFR values (P < .0001).
Concordance between software packages was excellent for MBF and MFR, despite higher values by PMOD at higher MBF values. Both software packages can be used interchangeably for quantification in daily practice of Rb-82 cardiac PET.
目前有几种用于从心脏PET研究中定量心肌血流量（MBF）的分析软件包，但尚未使用一致性分析对它们进行比较，一致性分析可以分别表征精密度和偏差。为了充分发挥其临床潜力，定量需要可重复的测量。
51例患者在静息和腺苷负荷状态下接受了动态Rb-82 PET检查。数据用PMOD和FlowQuant（洛蒂模型）进行处理。使用17节段模型对MBF和心肌血流储备（MFR）极坐标图进行定量和分析。比较采用Pearson相关系数ρ（测量精密度）、Bland和Altman一致性界限以及Lin一致性相关系数ρc = ρ·Cb（Cb测量系统偏差）。
Lin一致性和Pearson相关值非常相似，表明软件包之间没有系统偏差，MBF的精密度极佳（ρ = 0.97，ρc = 0.96，Cb = 0.99），MFR的精密度良好（ρ = 0.83，ρc = 0.76，Cb = 0.92）。在每节段基础上，Bland-Altman图上未观察到平均偏差，尽管在较高的MBF和MFR值时，PMOD提供的值略高于FlowQuant（P <.0001）。
尽管在较高的MBF值时PMOD的值较高，但软件包之间对于MBF和MFR的一致性极佳。在Rb-82心脏PET的日常实践中，两种软件包均可互换使用进行定量分析。
