应用动态双示踪剂 [N]NH3 和 [F]FDG PET/MRI 评估左、右心室功能参数。
Assessment of left and right ventricular functional parameters using dynamic dual-tracer [N]NH3 and [F]FDG PET/MRI.
机构信息
Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Floor 5L, 1090, Vienna, Austria.
Division of Cardiovascular and Interventional Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.
出版信息
J Nucl Cardiol. 2022 Jun;29(3):1003-1017. doi: 10.1007/s12350-020-02391-y. Epub 2020 Oct 22.
BACKGROUND
Cardiac positron emission tomography/magnetic resonance imaging (PET/MRI) can assess various cardiovascular diseases. In this study, we intra-individually compared right (RV) and left ventricular (LV) parameters obtained from dual-tracer PET/MRI scan.
METHODS
In 22 patients with coronary heart disease (69 ± 9 years) dynamic [N]NH (NH) and [F]FDG (FDG) PET scans were acquired. The first 2 minutes were used to calculate LV and RV first-pass ejection fraction (FPEF). Additionally, LV end-systolic (LVESV) and end-diastolic (LVEDV) volume and ejection fraction (LVEF) were calculated from the early (EP) and late-myocardial phases (LP). MRI served as a reference.
RESULTS
RVFPEF and LVFPEF from FDG and NH as well as RVEF and LVEF from MRI were (28 ± 11%, 32 ± 15%), (32 ± 11%, 41 ± 14%) and (42 ± 16%, 45 ± 19%), respectively. LVESV, LVEDV and LVEF from EP FDG and NH in 8 and 16 gates were [71 (15 to 213 mL), 98 (16 to 241 mL), 32 ± 17%] and [50 (17 to 206 mL), 93 (13 to 219 mL), 36 ± 17%] as well as [60 (19 to 360 mL), 109 (56 to 384 mL), 41 ± 22%] and [54 (16 to 371 mL), 116 (57 to 431 mL), 46 ± 24%], respectively. Moreover, LVESV, LVEDV and LVEF acquired from LP FDG and NH were (85 ± 63 mL, 138 ± 63 mL, 47 ± 19%) and (79 ± 56 mL, 137 ± 63 mL, 47 ± 20%), respectively. The LVESV, LVEDV from MRI were 93 ± 66 mL and 153 ± 71 mL, respectively. Significant correlations were observed for RVFPEF and LVFPEF between FDG and MRI (R = .51, P = .01; R = .64, P = .001), respectively. LVESV, LVEDV, and LVEF revealed moderate to strong correlations to MRI when they acquired from EP FDG and NH in 16 gates (all R > .7, P = .000). Similarly, all LV parameters from LP FDG and NH correlated good to strongly positive with MRI (all R > .7, and P < .001), except EDV from NH3 weakly correlated to EDV of MRI (R = .54, P < .05). Generally, Bland-Altman plots showed good agreements between PET and MRI.
CONCLUSIONS
Deriving LV and RV functional values from various phases of dynamic NH and FDG PET is feasible. These results could open a new perspective for further clinical applications of the PET examinations.
背景
心脏正电子发射断层扫描/磁共振成像（PET/MRI）可用于评估各种心血管疾病。在这项研究中，我们对冠状动脉疾病患者（69 ± 9 岁）进行的双示踪剂 PET/MRI 扫描，进行了个体内比较，以获得右心室（RV）和左心室（LV）参数。
方法
22 例患者进行了[¹⁵N]NH（NH）和[¹⁸F]FDG（FDG）动态 PET 扫描。前 2 分钟用于计算 LV 和 RV 首过射血分数（FPEF）。此外，还从早期（EP）和晚期心肌相（LP）计算了 LV 收缩末期（LVESV）和舒张末期（LVEDV）容积和射血分数（LVEF）。MRI 作为参考。
结果
FDG 和 NH 的 RVFPEF 和 LVFPEF 以及 MRI 的 RVEF 和 LVEF 分别为（28 ± 11%，32 ± 15%）、（32 ± 11%，41 ± 14%）和（42 ± 16%，45 ± 19%）。EP FDG 和 NH 的 8 个和 16 个门的 LVESV、LVEDV 和 LVEF 分别为[71（15 至 213 毫升），98（16 至 241 毫升），32 ± 17%]和[50（17 至 206 毫升），93（13 至 219 毫升），36 ± 17%]以及[60（19 至 360 毫升），109（56 至 384 毫升），41 ± 22%]和[54（16 至 371 毫升），116（57 至 431 毫升），46 ± 24%]。此外，LP FDG 和 NH 的 LVESV、LVEDV 和 LVEF 分别为（85 ± 63 毫升，138 ± 63 毫升，47 ± 19%）和（79 ± 56 毫升，137 ± 63 毫升，47 ± 20%）。MRI 的 LVESV 和 LVEDV 分别为 93 ± 66 毫升和 153 ± 71 毫升。FDG 和 MRI 之间的 RVFPEF 和 LVFPEF 存在显著相关性（R =.51，P =.01；R =.64，P =.001）。LVESV、LVEDV 和 LVEF 在 EP FDG 和 NH 的 16 个门中，与 MRI 具有中度至强相关性（所有 R >.7，P =.000）。同样，LP FDG 和 NH 的所有 LV 参数与 MRI 均呈良好至强正相关（所有 R >.7，P <.001），除了 NH3 的 EDV 与 MRI 的 EDV 弱相关（R =.54，P <.05）。一般来说，Bland-Altman 图显示 PET 和 MRI 之间具有良好的一致性。
结论
从 NH 和 FDG PET 的各个相获得 LV 和 RV 功能值是可行的。这些结果为 PET 检查的进一步临床应用开辟了新的视角。
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