Roby Amanda, Harmon Lindsey, Sander Kelly, Bui Linh, Kitkungvan Danai, Patel Monica, Narula Jagat, Johnson Nils P, Gould K Lance
Weatherhead PET Center for Preventing and Reversing Atherosclerosis, Division of Cardiology, Department of Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Memorial Hermann Hospital, 6431 Fannin St., Room MSB 4.256 Houston, TX 77030, USA.
Eur Heart J Imaging Methods Pract. 2024 Dec 9;2(3):qyae115. doi: 10.1093/ehjimp/qyae115. eCollection 2024 Jul.
Quantitative rest-stress myocardial perfusion in millilitres per minute per gram among multiple 2D and 3D positron emission tomography-computed tomography (PET-CT) scanners is essential for personalized cardiac management and clinical trials. Accordingly, this study reports the accuracy and precision of quantitative rest-stress millilitres per minute per gram and coronary flow capacity among 2D and two different digital 3D silicon photomultiplier (SiPM) PET-CT scanners for quantifying the severity of coronary pathophysiology for clinical trials or guiding interventions vs. medical treatment.
One hundred seventy-one participants underwent 748 paired serial rest or stress PET perfusion imaging in the same person on 'same day' or 'different days' using rubidium-82 (Rb-82) pharmacologic stress on 2D and two different digital 3D SiPM PET-CT scanners for global myocardial perfusion in millilitres per minute per gram. For methodological variability of 66 'same-day' serial paired PETs in the same person by 2D and two different 3D SiPM PET-CT scanners, rest-stress global myocardial millilitres per minute per gram had no significant bias ( = 0.464, mean difference 0.014 ± 0.21 mL/min/g) with coefficient of variation (COV) of ±14%. For methodological plus biological variability of 154 'different-day' serial paired PETs, rest-stress global perfusion had no significant bias ( = 0.136), mean difference (0.028 ± 0.33), and COV of ±20%. Coronary flow reserve had a small bias of 0.095 ± 0.57 ( = 0.041) and COV of ±20%. Coronary flow capacity was not different by Kolmogorov-Smirnov test ( = 0.99).
For quantifying myocardial perfusion in the same person on 'same day' or 'different days' using Rb-82, 3D SiPM PET-CT is comparably reproducible to analogue 2D PET-CT with the HeartSee perfusion model as the basis for quantifying physiologic severity of coronary heart disease to guide clinical decision-making or randomized clinical trials confirming these outcomes.
在多台二维和三维正电子发射断层扫描-计算机断层扫描（PET-CT）扫描仪中，以每分钟每克心肌的毫升数来定量静息-负荷心肌灌注，对于个性化心脏管理和临床试验至关重要。因此，本研究报告了在二维和两种不同的数字三维硅光电倍增管（SiPM）PET-CT扫描仪中，每分钟每克心肌的定量静息-负荷毫升数及冠状动脉血流容量的准确性和精密度，以量化冠状动脉病理生理学的严重程度，用于临床试验或指导干预措施与药物治疗的比较。
171名参与者在同一天或不同天，使用82铷（Rb-82）药物负荷，在二维和两种不同的数字三维SiPM PET-CT扫描仪上，对同一人进行了748次配对的系列静息或负荷PET灌注成像，以测量以每分钟每克心肌的毫升数表示的整体心肌灌注。对于二维和两种不同的三维SiPM PET-CT扫描仪在同一人身上进行的66次“同一天”系列配对PET的方法学变异性，静息-负荷整体心肌每分钟每克的毫升数无显著偏差（P = 0.464，平均差异0.014±0.21 mL/min/g），变异系数（COV）为±14%。对于154次“不同天”系列配对PET的方法学加生物学变异性，静息-负荷整体灌注无显著偏差（P = 0.136），平均差异（0.028±0.33），COV为±20%。冠状动脉血流储备有一个小偏差，为0.095±0.57（P = 0.041），COV为±20%。通过柯尔莫哥洛夫-斯米尔诺夫检验，冠状动脉血流容量无差异（P = 0.99）。
对于使用Rb-82在同一天或不同天对同一人进行心肌灌注定量，以HeartSee灌注模型为基础，三维SiPM PET-CT与模拟二维PET-CT具有相当的可重复性，可用于量化冠心病的生理严重程度，以指导临床决策或证实这些结果的随机临床试验。
