Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada.
Faculty of Medicine, University of Ottawa, Ottawa, Canada.
J Nucl Cardiol. 2023 Jun;30(3):1133-1146. doi: 10.1007/s12350-022-03134-x. Epub 2022 Dec 2.
Patient motion reduces the accuracy of PET myocardial blood flow (MBF) measurements. This study evaluated the effect of automatic motion correction on test-retest repeatability and inter-observer variability in a clinically relevant population.
Patients with known or suspected CAD underwent repeat rest Rb PET scans within minutes as part of their scheduled rest-stress perfusion study. Two trained observers evaluated the presence of heart motion in each scan. Global LV and per-vessel MBF were computed from the dynamic rest images before and after automatic motion correction. Test-retest and inter-observer variability were assessed using intra-class correlation and Bland-Altman analysis.
140 pairs of test-retest scans were included, with visual motion noted in 18%. Motion correction decreased the global MBF values by 3.5% (0.80 ± 0.24 vs 0.82 ± 0.25 mL⋅min⋅g; P < 0.001) suggesting that the blood input function was underestimated in cases with patient motion. Test-retest repeatability of global MBF improved by 9.7% (0.25 vs 0.28 mL⋅min⋅g; P < 0.001) and inter-observer repeatability was improved by 7.1% (0.073 vs 0.079 mL⋅min⋅g; P = 0.012). There was a marked impact on both test-retest repeatability as well as inter-observer repeatability in the LCX territory, with improvements of 16.5% (0.30 vs 0.36 mL⋅min⋅g; P < 0.0000) and 18.4% (0.13 vs 0.16 mL⋅min⋅g; P < 0.001), respectively.
Automatic motion correction improved test-retest repeatability and reduced differences between observers.
患者运动降低了 PET 心肌血流（MBF）测量的准确性。本研究评估了自动运动校正对临床相关人群中测试-再测试重复性和观察者间变异性的影响。
已知或疑似 CAD 的患者在其规定的静息-应激灌注研究中在数分钟内进行重复静息 Rb PET 扫描。两名经过培训的观察者评估了每个扫描中的心脏运动情况。在自动运动校正前后，从动态静息图像中计算出整体 LV 和每支血管的 MBF。使用组内相关和 Bland-Altman 分析评估测试-再测试和观察者间的变异性。
共纳入 140 对测试-再测试扫描，其中 18%存在视觉运动。运动校正使整体 MBF 值降低了 3.5%（0.80±0.24 vs 0.82±0.25 mL·min·g；P<0.001），表明在有患者运动的情况下，血输入函数被低估。整体 MBF 的测试-再测试重复性提高了 9.7%（0.25 vs 0.28 mL·min·g；P<0.001），观察者间的重复性提高了 7.1%（0.073 vs 0.079 mL·min·g；P=0.012）。LCX 区域的测试-再测试重复性和观察者间重复性均有明显改善，分别提高了 16.5%（0.30 vs 0.36 mL·min·g；P<0.0000）和 18.4%（0.13 vs 0.16 mL·min·g；P<0.001）。
自动运动校正提高了测试-再测试的重复性，减少了观察者之间的差异。
