Abstract
Aim/Introduction: Gated cardiac positron emission tomography
(PET) is an imaging technique that synchronizes acquired PET
data to the heart cycle based on electrocardiogram (ECG) signal.
Gated series provide quantitative functional parameters of
the left ventricle (LV), namely LV ejection fraction, end-systolic
volume (ESV) and end-diastolic volume (EDV), typically used for
risk stratifcation and prognosis in coronary artery disease (CAD).
However, cardiac PET often comprises artifacts related with
cardiac, respiratory and/or patient motion, which can lead to
misinterpretation of the results. Previous studies have suggested
that LV function parameters, particularly ESV and EF could be
under- and overestimated respectively, due to presence of motion
artifacts. Motion correction (MC) tools have been developed to
overcome this drawback, such as CardioFreeze with dual-gating
technology and data driven motion correction (DDMC). This
study aims to elucidate the efect of these tools in LV function
assessment. Materials and Methods: Twenty-four patients
with suspected CAD that underwent gated 13N-NH3
PET/CT in
the Northwest Clinics Alkmaar (Netherlands) from 28-07-2020
to 15-12-2020 were retrospectively included. Inclusion criteria:
no history of CAD, normal perfusion and LV-function, follow-up
since the time of study without major adverse cardiac events or
recurrent symptomatology. Four reconstructions were performed:
no motion correction (NMC), CardioFreeze, DDMC and DDMC
& CardioFreeze. Analysis was done with Cedars-Sinai QPET
software. Clinical data, LVEF and LV volumes in rest and stress
were acquired for the fnal analysis. For statistical analysis paired
T-tests were performed to compare the LV parameters with and
without the MC tools. Results: Study population consisted of
24 patients (62.5% women), all patients older than 42 years old,
and 22 (91.6%) vasodilated with adenosine. With regard to EDV
rest and stress, signifcant diferences were found only between
the NMC and DDMC groups (p<0.01). Regarding ESV and EF in
both rest and stress signifcant diferences were found between
NMC with CardioFreeze, DDMC and CardioFreeze & DDMC
(p<0.001). Larger mean diferences with NMC are measured
after applying CardioFreeze & DDMC (ESV rest: -5.42, ESV stress:
-6.54, LVEF rest: 5.13% and LVEF stress: 6.08%) Interestingly, of
both individual MC tools, CardioFreeze demonstrated larger
mean diferences. Conclusion: The use of motion correction
tools increase signifcantly ESV values and decrease signifcantly
EF values, with larger diferences after applying two combined
tools of motion correction, CardioFreeze & DDMC. References:
Tang et. al. Enhancing ejection fraction measurement through 4D
respiratory motion compensation in cardiac PET imaging. Phys
Med Biol. 2017 Jun 7;62(11):4496-4513
(PET) is an imaging technique that synchronizes acquired PET
data to the heart cycle based on electrocardiogram (ECG) signal.
Gated series provide quantitative functional parameters of
the left ventricle (LV), namely LV ejection fraction, end-systolic
volume (ESV) and end-diastolic volume (EDV), typically used for
risk stratifcation and prognosis in coronary artery disease (CAD).
However, cardiac PET often comprises artifacts related with
cardiac, respiratory and/or patient motion, which can lead to
misinterpretation of the results. Previous studies have suggested
that LV function parameters, particularly ESV and EF could be
under- and overestimated respectively, due to presence of motion
artifacts. Motion correction (MC) tools have been developed to
overcome this drawback, such as CardioFreeze with dual-gating
technology and data driven motion correction (DDMC). This
study aims to elucidate the efect of these tools in LV function
assessment. Materials and Methods: Twenty-four patients
with suspected CAD that underwent gated 13N-NH3
PET/CT in
the Northwest Clinics Alkmaar (Netherlands) from 28-07-2020
to 15-12-2020 were retrospectively included. Inclusion criteria:
no history of CAD, normal perfusion and LV-function, follow-up
since the time of study without major adverse cardiac events or
recurrent symptomatology. Four reconstructions were performed:
no motion correction (NMC), CardioFreeze, DDMC and DDMC
& CardioFreeze. Analysis was done with Cedars-Sinai QPET
software. Clinical data, LVEF and LV volumes in rest and stress
were acquired for the fnal analysis. For statistical analysis paired
T-tests were performed to compare the LV parameters with and
without the MC tools. Results: Study population consisted of
24 patients (62.5% women), all patients older than 42 years old,
and 22 (91.6%) vasodilated with adenosine. With regard to EDV
rest and stress, signifcant diferences were found only between
the NMC and DDMC groups (p<0.01). Regarding ESV and EF in
both rest and stress signifcant diferences were found between
NMC with CardioFreeze, DDMC and CardioFreeze & DDMC
(p<0.001). Larger mean diferences with NMC are measured
after applying CardioFreeze & DDMC (ESV rest: -5.42, ESV stress:
-6.54, LVEF rest: 5.13% and LVEF stress: 6.08%) Interestingly, of
both individual MC tools, CardioFreeze demonstrated larger
mean diferences. Conclusion: The use of motion correction
tools increase signifcantly ESV values and decrease signifcantly
EF values, with larger diferences after applying two combined
tools of motion correction, CardioFreeze & DDMC. References:
Tang et. al. Enhancing ejection fraction measurement through 4D
respiratory motion compensation in cardiac PET imaging. Phys
Med Biol. 2017 Jun 7;62(11):4496-4513
| Original language | English |
|---|---|
| Pages | S108 |
| Number of pages | 1 |
| Publication status | Published - 18-Aug-2023 |