Assessment of endothelial function and myocardial flow reserve using (15)O-water PET without attenuation correction.
OBJECTIVE
Myocardial blood flow (MBF) measurement using positron emission tomography (PET) from the washout rate of (15)O-water is theoretically independent of tissue attenuation. The aim of this study was to evaluate the impact of not using attenuation correction in the assessment of coronary endothelial function and myocardial flow reserve (MFR) using (15)O-water PET.


METHODS
We retrospectively processed 70 consecutive (15)O-water PET examinations obtained at rest and during cold pressor testing (CPT) in patients with dilated cardiomyopathy (n = 58), or at rest and during adenosine infusion in heart transplant recipients (n = 12). Data were reconstructed with attenuation correction (AC) and without attenuation correction (NAC) using filtered backprojection, and MBF was quantified using a single compartmental model. The agreement between AC and NAC data was assessed using Lin's concordance correlation coefficient followed by Bland-Altman plot analysis.


RESULTS
Regarding endothelial function, NAC PET showed poor reproducibility and poor agreement with AC PET data. Conversely, NAC PET demonstrated high reproducibility and a strong agreement with AC PET for the assessment of MFR.


CONCLUSIONS
Non-attenuation-corrected (15)O-water PET provided an accurate measurement of MFR compared to attenuation-corrected PET. However, non-attenuation-corrected PET data were less effective for the assessment of endothelial function using CPT in this population.
Normandie Université, EA 4650, Caen, France.
Stéphane
S
Tuffier
Normandie Université, EA 4650, Caen, France.|Department of Cardiology, Caen University Hospital, Caen, France.
Damien
D
Legallois
Department of Cardiac Surgery, Caen University Hospital, Caen, France.
Annette
A
Belin
Normandie Université, EA 4650, Caen, France.
Michael
M
Joubert
Normandie Université, EA 4650, Caen, France.
Alban
A
Bailliez
Department of Cardiac Surgery, Rouen University Hospital, Rouen, France.
Michel
M
Redonnet
Normandie Université, EA 4650, Caen, France.|Department of Nuclear Medicine, Caen University Hospital, Caen, France.
Denis
D
Agostini
Normandie Université, EA 4650, Caen, France. manrique@cyceron.fr.|Department of Nuclear Medicine, Caen University Hospital, Caen, France. manrique@cyceron.fr.|Cyceron PET Centre, Caen, France. manrique@cyceron.fr.
Alain
A
Manrique
D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging*; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D010104:Oxygen Radioisotopes; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results
D010104:Oxygen Radioisotopes; D019275:Radiopharmaceuticals
15O-water; Attenuation correction; Endothelial function; Myocardial flow reserve; Myocardial perfusion; Positron emission tomography