Feasibility and operator variability of myocardial blood flow and reserve measurements with 99mTc-sestamibi quantitative dynamic SPECT/CT imaging
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- 作者：Ran Klein PhD (1)
Guang-Uei Hung MD (2)
Tao-Cheng Wu MD (3)
Wen-Sheng Huang MD (4)
Dianfu Li MD ; PhD (5)
Robert A. deKemp PhD (1)
Bailing Hsu PhD (6) - 关键词：Myocardial flow reserve ; image quantification ; dynamic SPECT ; operator variability ; 99mTc ; sestamibi
- 刊名：Journal of Nuclear Cardiology
- 出版年：2014
- 出版时间：December 2014
- 年：2014
- 卷：21
- 期：6
- 页码：1075-1088
- 全文大小：1,710 KB
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15. Katoh C, Yoshinaga K, Klein R, Kasai K, Tomiyama Y, Manabe O, et al. Quantification of regional myocardial blood flow estimation with three-dimensional dynamic rubidium-82 - 作者单位：Ran Klein PhD (1)
Guang-Uei Hung MD (2)
Tao-Cheng Wu MD (3)
Wen-Sheng Huang MD (4)
Dianfu Li MD, PhD (5)
Robert A. deKemp PhD (1)
Bailing Hsu PhD (6)
1. University of Ottawa Heart Institute, Cardiac PET Centre, 40 Ruskin St., Ottawa, ON, K1Y 4W7, Canada
2. Department of Nuclear Medicine, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan
3. Section of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
4. Departments of Medical Research & Nuclear Medicine, Changhua Christian Hospital, Changhua, Taiwan
5. Section of Nuclear Cardiology, Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
6. Nuclear Science and Engineering Institute, University of Missouri-Columbia, Columbia, MO, 65211, USA - ISSN：1532-6551
文摘
Purpose Myocardial blood flow (MBF) quantification with dynamic SPECT could lead to widespread utilization of MBF imaging in clinical practice with little cost increase over current standard SPECT myocardial perfusion imaging. This work evaluates the feasibility and operator-dependent variability of MBF and flow reserve measurements with 99mTc-sestamibi (MIBI) dynamic SPECT imaging using a standard dual-head SPECT camera. Methods Twenty-eight patients underwent dipyridamole-stress and rest imaging with dynamic SPECT/CT acquisition. Quantitative images were iteratively reconstructed with all physical corrections and then myocardial and arterial blood regions of interest (ROI) were defined semi-automatically. A compartmental model was fitted to these ROI-sampled time-activity-curves, and flow-dependent MIBI extraction correction was applied to derive regional MBF values. Myocardial flow reserve (MFR) was estimated as stress/rest MBF ratio. MBF and MFR in low and high risk populations were evaluated for ability to detect disease. Images were each processed twice (??days apart) by one expert and one novice operator to evaluate intra- and inter-operator variability of MBF and MFR measurement in the three coronary artery vascular territories. Results Mean rest flow, stress flow, and MFR values were 0.83, 1.82?mL·minute?·g?, and 2.45, respectively. For stress/rest MFR, the inter-operator reproducibility was r 2?=?0.86 with RPC?=?1.1. Stress MBF and MFR were significantly reduced (P?r 2?=?0.98 and 0.95 (n?=?168, P??·g? for the expert and novice operators, respectively (P?r 2?=?0.91 and Bland-Altman RPC?=?0.58?mL·minute?·g? (n?=?336). Conclusions MBF and reserve measurements using 99mTc-sestamibi on a traditional, two-headed camera with fast rotation and with quantitative dynamic SPECT appears to be feasible, warranting further investigation.