title: Dual-Gated Motion-Frozen Cardiac PET with Flurpiridaz F 18.
abstract: A novel PET radiotracer, Flurpiridaz F 18, has undergone phase II clinical trial evaluation as a high-resolution PET cardiac perfusion imaging agent. In a subgroup of patients imaged with this agent, we assessed the feasibility and benefit of simultaneous correction of respiratory and cardiac motion.
  
  
  METHODS
  In 16 patients, PET imaging was performed on a 4-ring scanner in dual cardiac and respiratory gating mode. Four sets of data were reconstructed with high-definition reconstruction (HD•PET): ungated and 8-bin electrocardiography-gated images using 5-min acquisition, optimal respiratory gating (ORG)-as developed for oncologic imaging-using a narrow range of breathing amplitude around end-expiration level with 35% of the counts in a 7-min acquisition, and 4-bin respiration-gated and 8-bin electrocardiography-gated images (32 bins in total) using the 7-min acquisition (dual-gating, using all data). Motion-frozen (MF) registration algorithms were applied to electrocardiography-gated and dual-gated data, creating cardiac-MF and dual-MF images. We computed wall thickness, wall/cavity contrast, and contrast-to-noise ratio for standard, ORG, cardiac-MF, and dual-MF images to assess image quality.
  
  
  RESULTS
  The wall/cavity contrast was similar for ungated (9.3 ± 2.9) and ORG (9.5 ± 3.2) images and improved for cardiac-MF (10.8 ± 3.6) and dual-MF images (14.8 ± 8.0) (P < 0.05). The contrast-to-noise ratio was 22.2 ± 9.1 with ungated, 24.7 ± 12.2 with ORG, 35.5 ± 12.8 with cardiac-MF, and 42.1 ± 13.2 with dual-MF images (all P < 0.05). The wall thickness was significantly decreased (P < 0.05) with dual-MF (11.6 ± 1.9 mm) compared with ungated (13.9 ± 2.8 mm), ORG (13.1 ± 2.9 mm), and cardiac-MF images (12.1 ± 2.7 mm).
  
  
  CONCLUSIONS
  Dual (respiratory/cardiac)-gated perfusion imaging with Flurpiridaz F 18 is feasible and improves image resolution, contrast, and contrast-to-noise ratio when MF registration methods are applied.
authors.affiliation: Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, California Siemens Healthcare Molecular Imaging, Knoxville, Tennessee piotr.slomka@cshs.org.
authors.forename: Piotr J
authors.initials: PJ
authors.lastname: Slomka
authors.affiliation: Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Rubeaux
authors.affiliation: Siemens Healthcare Molecular Imaging, Knoxville, Tennessee.
authors.forename: Ludovic
authors.initials: L
authors.lastname: Le Meunier
authors.affiliation: Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Damini
authors.initials: D
authors.lastname: Dey
authors.affiliation: Lantheus Medical Imaging, North Billerica, Massachusetts.
authors.forename: Joel L
authors.initials: JL
authors.lastname: Lazewatsky
authors.affiliation: MD Anderson Center, Houston, Texas; and.
authors.forename: Tinsu
authors.initials: T
authors.lastname: Pan
authors.affiliation: University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: Marc R
authors.initials: MR
authors.lastname: Dweck
authors.affiliation: University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: David E
authors.initials: DE
authors.lastname: Newby
authors.affiliation: Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Guido
authors.initials: G
authors.lastname: Germano
authors.affiliation: Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Berman
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D004562:Electrocardiography; D005260:Female; D015637:Gated Blood-Pool Imaging; D006321:Heart / Q000000981:diagnostic imaging* / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000166:cytology; D049268:Positron-Emission Tomography / Q000379:methods*; D011724:Pyridazines; D019275:Radiopharmaceuticals; D015656:Respiratory Mechanics
chemical_list: C525920:BMS 747158-02; D011724:Pyridazines; D019275:Radiopharmaceuticals
keywords: PET; cardiac PET; cardiology (basic/technical); cardiology (clinical); flurpiridaz; motion-frozen