Hansson Nils Henrik, Tolbod Lars, Harms Hendrik Johannes, Wiggers Henrik, Kim Won Yong, Hansen Esben, Zaremba Tomas, Frøkiær Jørgen, Jakobsen Steen, Sørensen Jens
Department of Cardiology, Aarhus University Hospital, Aarhus C, Denmark.
Department of Nuclear Medicine & PET-Centre, Aarhus University Hospital, Aarhus C, Denmark.
J Nucl Cardiol. 2016 Aug;23(4):670-9. doi: 10.1007/s12350-015-0331-0. Epub 2016 Apr 19.
Noninvasive estimation of myocardial external efficiency (MEE) requires measurements of left ventricular (LV) oxygen consumption with [(11)C]acetate PET in addition to LV stroke volume and mass with cardiovascular magnetic resonance (CMR). Measuring LV geometry directly from ECG-gated [(11)C]acetate PET might enable MEE evaluation from a single PET scan. Therefore, we sought to establish the accuracy of measuring LV volumes, mass, and MEE directly from ECG-gated [(11)C]acetate PET.
Thirty-five subjects with aortic valve stenosis underwent ECG-gated [(11)C]acetate PET and CMR. List mode PET data were rebinned into 16-bin ECG-gated uptake images before measuring LV volumes and mass using commercial software and compared to CMR. Dynamic datasets were used for calculation of mean LV oxygen consumption and MEE.
LV mass, volumes, and ejection fraction measured by CMR and PET correlated strongly (r = 0.86-0.92, P < .001 for all), but were underestimated by PET (P < .001 for all except ESV P = .79). PET-based MEE, corrected for bias, correlated fairly with PET/CMR-based MEE (r = 0.60, P < .001, bias -3 ± 21%, P = .56). PET-based MEE bias was strongly associated with LV wall thickness.
Although analysis-related improvements in accuracy are recommended, LV geometry estimated from ECG-gated [(11)C]acetate PET correlate excellently with CMR and can indeed be used to evaluate MEE.
无创评估心肌外在效率（MEE）除了需要利用心血管磁共振（CMR）测量左心室（LV）的每搏输出量和质量外，还需要通过[¹¹C]乙酸PET测量LV的氧耗量。直接从心电图门控的[¹¹C]乙酸PET测量LV几何形态可能使得能够从单次PET扫描评估MEE。因此，我们试图确定直接从心电图门控的[¹¹C]乙酸PET测量LV容积、质量和MEE的准确性。
35例主动脉瓣狭窄患者接受了心电图门控的[¹¹C]乙酸PET和CMR检查。在使用商业软件测量LV容积和质量之前，将列表模式PET数据重新组合为16帧心电图门控摄取图像，并与CMR结果进行比较。动态数据集用于计算LV平均氧耗量和MEE。
CMR和PET测量的LV质量、容积和射血分数相关性很强（所有r = 0.86 - 0.92，P <.001），但PET测量值低于实际值（除ESV外，所有P <.001，ESV的P =.79）。校正偏差后的基于PET的MEE与基于PET/CMR的MEE相关性尚可（r = 0.60，P <.001，偏差 - 3 ± 21%，P =.56）。基于PET的MEE偏差与LV壁厚度密切相关。
尽管建议在分析方面进一步提高准确性，但从心电图门控的[¹¹C]乙酸PET估计的LV几何形态与CMR具有极好的相关性，确实可用于评估MEE。
