Impact of point spread function modeling and time-of-flight on myocardial blood flow and myocardial flow reserve measurements for rubidium-82 cardiac PET.
BACKGROUND
Myocardial flow reserve (MFR) obtained from dynamic cardiac positron emission tomography (PET) with rubidium-82 (Rb-82) has been shown to be a useful measurement in assessing coronary artery disease. Advanced PET reconstructions with point spread function modeling and time-of-flight have been shown to improve image quality but also have an impact on kinetic analysis of dynamic data. This study aims to determine the impact of these algorithms on MFR data.


METHODS
Dynamic Rb-82 cardiac PET images from 37 patients were reconstructed with standard and advanced reconstructions. Area under curve (AUC) of the blood input function (BIF), myocardial blood flow (MBF) and MFR were compared with each reconstruction.


RESULTS
No significant differences were seen in MFR for the two reconstructions. A relatively small mean difference in MBF data of +11.9% was observed with advanced reconstruction compared with the standard reconstruction but there was considerable variability in the degree of change (95% confidence intervals of -16.2% to +40.0%). Small systematic relative differences were seen for AUC BIF (mean difference of -6.3%; 95% CI -17.5% to +5.4%).


CONCLUSIONS
MFR results from Rb-82 dynamic PET appear to be robust when generated by standard or advanced PET reconstructions. Considerable increases in MBF values may occur with advanced reconstructions, and further work is required to fully understand this.
Nuclear Medicine, Central Manchester University Hospitals, Oxford Road, Manchester, UK, ian.armstrong@cmft.nhs.uk.
Ian S
IS
Armstrong
Christine M
CM
Tonge
Parthiban
P
Arumugam
D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D003326:Coronary Circulation; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D008955:Models, Cardiovascular; D015233:Models, Statistical; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D015203:Reproducibility of Results; D012414:Rubidium Radioisotopes / Q000493:pharmacokinetics*; D012680:Sensitivity and Specificity
D019275:Radiopharmaceuticals; D012414:Rubidium Radioisotopes