Tsj Opstal, Rjj Knol, Jh Cornel, M Wondergem, Fm van der Zant
Department of Nuclear Medicine, North West Clinics, Alkmaar, The Netherlands.
Department of Cardiology, North West Clinics, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands.
Eur J Hybrid Imaging. 2018;2(1):11. doi: 10.1186/s41824-018-0029-z. Epub 2018 Jun 11.
Cardiac imaging by means of myocardial Positron Emission Tomography/Computed Tomography (PET/CT) is being used increasingly to assess coronary artery disease, to guide revascularization decisions with more accuracy, and it allows robust quantitative analysis of both regional myocardial blood flow (MBF) and myocardial flow reserve (MFR).Recently, a more time-efficient protocol has been developed in combination with a residual activity correction algorithm in which a stress acquisition is performed directly after completion of the rest acquisition to subtract remaining myocardial radioactivity.The objective of this study is to define flow values of myocardial blood flow (MBF) and Myocardial Flow Reserve (MFR) with N-ammonia (NH) myocardial perfusion PET/CT on patients without coronary artery disease using a time-efficient protocol, since reference values for this particular type of study are lacking in literature. In addition, we aim to determine the effect of the residual activity correction algorithm in this time-efficient protocol.
A mean MBF in rest of 1.02 ± 0.22 ml/g/min, a mean MBF in stress of 2.54 ± 0.41 ml/g/min with a mean MFR of 2.60 ± 0.61 were measured. Female patients had a significant higher MBF in rest and stress, but lower MFR; a small but significant negative correlation was measured between age and MBF in stress and MFR. Residual activity correction had a significant effect resulting in a difference in global stress MBF before and after correction of 0.39 ± 0.13 ml/g/min.
This study established flow values for NH myocardial PET/CT with a time-efficient protocol, and established that MBF in stress corrected for residual activity is comparable with known reference values in normal studies without temporal overlap. Further validation of the technique could be of value, e.g. by comparison to standard imaging without temporal overlap, or validation against catheterization results.
通过心肌正电子发射断层扫描/计算机断层扫描（PET/CT）进行心脏成像越来越多地用于评估冠状动脉疾病，更准确地指导血运重建决策，并且它能够对局部心肌血流量（MBF）和心肌血流储备（MFR）进行可靠的定量分析。最近，结合残余活性校正算法开发了一种更省时的方案，其中在静息采集完成后直接进行负荷采集，以减去心肌残留放射性。本研究的目的是使用省时方案，确定无冠状动脉疾病患者的N-氨（NH）心肌灌注PET/CT的心肌血流量（MBF）和心肌血流储备（MFR）的血流值，因为文献中缺乏此类特定研究的参考值。此外，我们旨在确定在该省时方案中残余活性校正算法的效果。
测得静息时平均MBF为1.02±0.22ml/g/min，负荷时平均MBF为2.54±0.41ml/g/min，平均MFR为2.60±0.61。女性患者静息和负荷时的MBF显著更高，但MFR更低；年龄与负荷时的MBF和MFR之间存在小但显著的负相关。残余活性校正有显著效果，校正前后整体负荷MBF的差异为0.39±0.13ml/g/min。
本研究使用省时方案确定了NH心肌PET/CT的血流值，并确定校正残余活性后的负荷MBF与无时间重叠的正常研究中的已知参考值相当。该技术的进一步验证可能有价值，例如通过与无时间重叠的标准成像进行比较，或与导管检查结果进行验证。
