title: Myocardial blood flow quantification by Rb-82 cardiac PET/CT: A detailed reproducibility study between two semi-automatic analysis programs.
abstract: Several analysis software packages for myocardial blood flow (MBF) quantification from cardiac PET studies exist, but they have not been compared using concordance analysis, which can characterize precision and bias separately. Reproducible measurements are needed for quantification to fully develop its clinical potential.
  
  
  
  Fifty-one patients underwent dynamic Rb-82 PET at rest and during adenosine stress. Data were processed with PMOD and FlowQuant (Lortie model). MBF and myocardial flow reserve (MFR) polar maps were quantified and analyzed using a 17-segment model. Comparisons used Pearson's correlation ρ (measuring precision), Bland and Altman limit-of-agreement and Lin's concordance correlation ρc = ρ·C b (C b measuring systematic bias).
  
  
  
  Lin's concordance and Pearson's correlation values were very similar, suggesting no systematic bias between software packages with an excellent precision ρ for MBF (ρ = 0.97, ρc = 0.96, C b = 0.99) and good precision for MFR (ρ = 0.83, ρc = 0.76, C b = 0.92). On a per-segment basis, no mean bias was observed on Bland-Altman plots, although PMOD provided slightly higher values than FlowQuant at higher MBF and MFR values (P < .0001).
  
  
  
  Concordance between software packages was excellent for MBF and MFR, despite higher values by PMOD at higher MBF values. Both software packages can be used interchangeably for quantification in daily practice of Rb-82 cardiac PET.
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
authors.forename: Vincent
authors.initials: V
authors.lastname: Dunet
authors.affiliation: University of Ottawa Heart Institute, Cardiac PET Centre, Ottawa, Canada.
authors.forename: Ran
authors.initials: R
authors.lastname: Klein
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
authors.forename: Gilles
authors.initials: G
authors.lastname: Allenbach
authors.affiliation: University of Ottawa Heart Institute, Cardiac PET Centre, Ottawa, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Renaud
authors.affiliation: University of Ottawa Heart Institute, Cardiac PET Centre, Ottawa, Canada.
authors.forename: Robert A
authors.initials: RA
authors.lastname: deKemp
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland. john.prior@chuv.ch.
authors.forename: John O
authors.initials: JO
authors.lastname: Prior
mesh_terms: D000465:Algorithms; D001783:Blood Flow Velocity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003326:Coronary Circulation; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D000069550:Machine Learning; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D010363:Pattern Recognition, Automated / Q000379:methods*; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012414:Rubidium Radioisotopes; D012680:Sensitivity and Specificity; D012984:Software
chemical_list: D019275:Radiopharmaceuticals; D012414:Rubidium Radioisotopes; C000615479:Rubidium-82
keywords: PET; Software; accuracy; agreement; comparison; concordance; myocardial perfusion; precision; quantification; rubidium-82