title: Optimally Repeatable Kinetic Model Variant for Myocardial Blood Flow Measurements with82Rb PET.
abstract: Purpose.Myocardial blood flow (MBF) quantification with82Rb positron emission tomography (PET) is gaining clinical adoption, but improvements in precision are desired. This study aims to identify analysis variants producing the most repeatable MBF measures.Methods.12 volunteers underwent same-day test-retest rest and dipyridamole stress imaging with dynamic82Rb PET, from which MBF was quantified using 1-tissue-compartment kinetic model variants: (1) blood-pool versus uptake region sampled input function (Blood/Uptake-ROI), (2) dual spillover correction (SOC-On/Off), (3) right blood correction (RBC-On/Off), (4) arterial blood transit delay (Delay-On/Off), and (5) distribution volume (DV) constraint (Global/Regional-DV). Repeatability of MBF, stress/rest myocardial flow reserve (MFR), and stress/rest MBF difference (ΔMBF) was assessed using nonparametric reproducibility coefficients (RPCnp= 1.45 × interquartile range).Results.MBF using SOC-On, RVBC-Off, Blood-ROI, Global-DV, and Delay-Off was most repeatable for combined rest and stress: RPCnp= 0.21 mL/min/g (15.8%). Corresponding MFR and ΔMBF RPCnpwere 0.42 (20.2%) and 0.24 mL/min/g (23.5%). MBF repeatability improved with SOC-On at stress (p< 0.001) and tended to improve with RBC-Off at both rest and stress (p< 0.08). DV and ROI did not significantly influence repeatability. The Delay-On model was overdetermined and did not reliably converge.Conclusion.MBF and MFR test-retest repeatability were the best with dual spillover correction, left atrium blood input function, and global DV.
authors.affiliation: Systems and Computer Engineering, Carleton University, Ottawa, ON, Canada.
authors.forename: Adrian F
authors.identifier: 0000-0002-4265-1608
authors.initials: AF
authors.lastname: Ocneanu
authors.affiliation: National Cardiac PET Centre, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Robert A
authors.initials: RA
authors.lastname: deKemp
authors.affiliation: National Cardiac PET Centre, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Renaud
authors.affiliation: Systems and Computer Engineering, Carleton University, Ottawa, ON, Canada.
authors.forename: Andy
authors.initials: A
authors.lastname: Adler
authors.affiliation: National Cardiac PET Centre, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Rob S B
authors.initials: RS
authors.lastname: Beanlands
authors.affiliation: Department of Nuclear Medicine, The Ottawa Hospital, Ottawa, ON, Canada; Division of Nuclear Medicine, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Ran
authors.initials: R
authors.lastname: Klein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000503:physiopathology; D003326:Coronary Circulation; D004176:Dipyridamole / Q000737:chemistry; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D049268:Positron-Emission Tomography; D011868:Radioisotopes; D015203:Reproducibility of Results; D012413:Rubidium / Q000737:chemistry*; D014057:Tomography, X-Ray Computed
chemical_list: D011868:Radioisotopes; D004176:Dipyridamole; D012413:Rubidium