Combining dynamic and ECG-gated ⁸²Rb-PET for practical implementation in the clinic.
Combining dynamic and ECG-gated ⁸²Rb-PET for practical implementation in the clinic.
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DOI：
10.1097/mnm.0b013e32834c13b5
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发表时间：
2012-01
影响因子：
1.5
通讯作者：
Seo Y
中科院分区：
文献类型：
--
作者：
Sayre GA;Bacharach SL;Dae MW;Seo Y
对于许多心脏诊所，列表模式PET是不切实际的。因此，需要单独的动态和心电图门控（ECG门控）采集来检测有害的狭窄;指示受影响的冠状动脉;并估计狭窄的严重程度。然而，医生通常仅由于剂量、时间和成本限制而订购门控研究，并且仅限于检测。为了消除这些限制，我们开发了一种新的曲线拟合算法（ICD），以准确地计算冠状动脉血流储备（CFR）的组合动态心电图协议的长度等于一个典型的门控扫描。我们缩短了几项回顾性动态研究，以模拟联合方案的缩短动态采集，并比较：1）ICD和标称方法外推动脉输入函数（AIF）的完整功能形式的准确性; 2）ICD和ICD-AP（ICD具有完整数据AIF的后验知识）预测CFR的准确性。根据Akaike信息标准，在11/12项研究中，ICD预测的AIF比标称方法预测的AIF更准确。ICD和ICD-AP预测的CFR与竞争数据预测相似（pICD = 0. 94和pICD-AP = 0. 91），平均误差相似（eICD = 2. 82%和eICD-AP = 2. 79%）。根据核心脏病专家和PET数据专家分析，ICD和ICD-AP预测CFR值具有足够的临床准确性。因此，通过使用我们的方法，心脏诊所的医生将能够获得必要的信息量，以区分单支和三支血管疾病，从而做出治疗决策。
For many cardiac clinics, list-mode PET is impractical. Thus, separate dynamic and electrocardiogram-gated (ECG-gated) acquisitions are needed to detect harmful stenoses; indicate affected coronary arteries; and estimate stenosis severity. However, physicians usually order gated studies only due to dose, time, and cost limitations and are limited to detection. In an effort to remove these limitations, we developed a novel curve-fitting algorithm (ICD) to accurately calculate coronary flow reserve (CFR) from a combined dynamic-ECG protocol of length equal to one typical gated scan. We shortened several retrospective dynamic studies to simulate shortened dynamic acquisitions of the combined protocol and compared: 1) the accuracy of ICD and a nominal method in extrapolating the complete functional form of arterial input functions (AIFs); and 2) the accuracy of ICD and ICD-AP (ICD with a posteriori knowledge of complete-data AIFs) in predicting CFRs. AIFs predicted by ICD were more accurate than those predicted by the nominal method in 11/12 studies according to the Akaike Information Criterion. CFRs predicted by ICD and ICD-AP were similar to compete-data predictions (pICD = 0.94 and pICD-AP = 0.91) and had similar average errors (eICD = 2.82% and eICD-AP = 2.79%). Both ICD and ICD-AP predicted CFR values with sufficient accuracy for the clinic according to a nuclear cardiologist and an expert analyst of PET data. Therefore, by using our method, physicians in cardiac clinics would have access to the necessary amount of information to differentiate between single-and triple- vessel disease for treatment decision-making.