Reproducibility and accuracy of quantitative myocardial blood flow assessment with (82)Rb PET: comparison with (13)N-ammonia PET.
Reproducibility and accuracy of quantitative myocardial blood flow assessment with (82)Rb PET: comparison with (13)N-ammonia PET.
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DOI：
10.2967/jnumed.104.007831
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发表时间：
2009-07
期刊：
影响因子：
--
通讯作者：
Di Carli MF
中科院分区：
文献类型：
--
作者：
El Fakhri G;Kardan A;Sitek A;Dorbala S;Abi-Hatem N;Lahoud Y;Fischman A;Coughlan M;Yasuda T;Di Carli MF
82 Rb心脏PET允许在缺乏回旋加速器的诊所中使用柱发生器评估心肌灌注。我们和其他人以前已经表明，心肌血流量（MBF）和冠状动脉血流储备（CFR）的定量是可行的，使用动态82 Rb PET和因子和房室分析。本工作的目的是确定使用82 Rb PET的MBF估计的观察者内和观察者间的变异性以及我们的广义因子+房室分析方法的再现性，以估计MBF，并通过比较，在相同的主题，82 Rb估计MBF使用13 N-氨获得的准确性评估其准确性。22例受试者被纳入重现性研究，20例受试者被纳入验证研究。患者注射60± 5 mCi的82 Rb，并在静息和双嘧达莫负荷期间动态成像6分钟。通过GFADS估计左心室和右心室（LV+RV）时间-活动曲线，并用作2室动力学分析的输入，该分析估计心肌组织提取（K1）和流出（k2）的参数图，以及LV+RV贡献（fv，rv）。我们的研究结果表明，定量动态方法本身具有良好的再现性，其重复性系数为1.7%，估计MBF在休息时，1.4%的MBF在峰值应力和2.8%的CFR估计。参与本研究的四名观察者之间的观察者间重现性也非常好，在估计冠状动脉血流储备时，任何两名观察者之间的相关系数均大于0.87。在重复的82 Rb研究中，MBF的再现性在静息状态下良好，在峰值应力下极好（r2=0.835）。此外，在重复的82 Rb研究中，当估计应力MBF和CFR时，相关线的斜率非常接近1。82 Rb和13 N-氨研究在静息和峰值应力期间获得的心肌血流估计值之间的相关性在静息（r2=0.843）和应力（r2=0.761）时非常好。Bland-Altman图显示在静息或应激时不存在显著的比例误差，也不存在对静息或应激时心肌血流振幅的变化依赖性。在静息状态下观察到13 N-氨MBF的小的系统性高估（0.129 ml/g/min），而相反，即，低估，在应力（0.22 ml/g/min）。我们的研究结果表明，绝对定量心肌血流量是可重复的和准确的82 Rb动态心脏PET相比，13 N-氨。定量方法本身的重现性以及观察员间重现性非常好。
82Rb cardiac PET allows the assessment of myocardial perfusion using a column generator in clinics that lack a cyclotron. We and others have previously shown that quantitation of myocardial blood flow (MBF) and coronary flow reserve (CFR) is feasible using dynamic 82Rb PET and factor and compartment analyses. The aim of the present work was to determine the intra- and inter-observer variability of MBF estimation using 82Rb PET as well as the reproducibility of our generalized factor + compartment analyses methodology to estimate MBF and assess its accuracy by comparing, in the same subjects, 82Rb estimates of MBF to those obtained using 13N-ammonia. Twenty-two subjects were included in the reproducibility and twenty subjects in the validation study. Patients were injected with 60±5mCi of 82Rb and imaged dynamically for 6 minutes at rest and during dipyridamole stress Left and right ventricular (LV+RV) time-activity curves were estimated by GFADS and used as input to a 2-compartment kinetic analysis that estimates parametric maps of myocardial tissue extraction (K1) and egress (k2), as well as LV+RV contributions (fv,rv). Our results show excellent reproducibility of the quantitative dynamic approach itself with coefficients of repeatability of 1.7% for estimation of MBF at rest, 1.4% for MBF at peak stress and 2.8% for CFR estimation. The inter-observer reproducibility between the four observers that participated in this study was also very good with correlation coefficients greater than 0.87 between any two given observers when estimating coronary flow reserve. The reproducibility of MBF in repeated 82Rb studies was good at rest and excellent at peak stress (r2=0.835). Furthermore, the slope of the correlation line was very close to 1 when estimating stress MBF and CFR in repeated 82Rb studies. The correlation between myocardial flow estimates obtained at rest and during peak stress in 82Rb and 13N-ammonia studies was very good at rest (r2=0.843) and stress (r2=0.761). The Bland-Altman plots show no significant presence of proportional error at rest or stress, nor a dependence of the variations on the amplitude of the myocardial blood flow at rest or stress. A small systematic overestimation of 13N-ammonia MBF was observed with 82Rb at rest (0.129 ml/g/min) and the opposite, i.e., underestimation, at stress (0.22 ml/g/min). Our results show that absolute quantitation of myocardial bloof flow is reproducible and accurate with 82Rb dynamic cardiac PET as compared to 13N-ammonia. The reproducibility of the quantitation approach itself was very good as well as inter-observer reproducibility.
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DOI：
10.1007/s00259-002-0796-3
发表时间：
2002-07-01
影响因子：
9.1
作者：
Burger, C;Goerres, G;von Schulthess, GK
通讯作者：
von Schulthess, GK
影响因子：
9.3
作者：
Di Carli, Marcelo F.;Dorbala, Sharmila;Moore, Stephen C.
通讯作者：
Moore, Stephen C.
影响因子：
37.8
作者：
Dahl, J;Muzik, O;Schwaiger, M
通讯作者：
Schwaiger, M
影响因子：
37.8
作者：
Nitzsche, EU;Choi, Y;Schelbert, HR
通讯作者：
Schelbert, HR
影响因子：
37.8
作者：
HERRERO, P;MARKHAM, J;BERGMANN, SR
通讯作者：
BERGMANN, SR