Optimization and Reproducibility of Aortic Valve 18F-Fluoride Positron Emission Tomography in Patients With Aortic Stenosis.
Optimization and Reproducibility of Aortic Valve 18F-Fluoride Positron Emission Tomography in Patients With Aortic Stenosis.
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DOI：
10.1161/circimaging.116.005131
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发表时间：
2016-10
期刊：
影响因子：
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通讯作者：
Dweck MR
中科院分区：
文献类型：
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作者：
Pawade TA;Cartlidge TR;Jenkins WS;Adamson PD;Robson P;Lucatelli C;Van Beek EJ;Prendergast B;Denison AR;Forsyth L;Rudd JH;Fayad ZA;Fletcher A;Tuck S;Newby DE;Dweck MR
文本中提供了补充数字内容。18F-氟化物正电子发射断层扫描（PET）和计算机断层扫描（CT）可以测量主动脉瓣狭窄的疾病活动和进展。我们的目标是优化主动脉瓣18F-氟化物PET-CT成像的方法学、分析和扫描-再扫描再现性。15例主动脉瓣狭窄患者接受了重复18F-氟化物PET-CT。我们比较了非增强PET和非增强CT，以及结合增强CT和ECG门控PET的改良方法。我们探讨了一系列的图像分析技术，包括估计血池活动在不同的血管网站和最患病的部分的方法。对比增强ECG门控PET-CT允许将18F-氟化物摄取定位到单个瓣叶。最常在最大机械应力部位观察到摄取：瓣叶尖端和连合处。使用增强的分析技术显著改善了扫描-再扫描再现性，导致误差百分比从±63%降低到±10%（组织与背景比MDS平均值为1.55，偏倚为-0.05，一致性限值为-0.20至+0统计11）。优化的18F-氟化物PET-CT允许将钙化活动可再现地定位到主动脉瓣叶的不同区域，通常定位到机械应力增加的区域。这项技术在提高我们对主动脉瓣狭窄的病理生理学的理解方面具有重要的前景，并作为新疗法临床试验的生物标志物终点。URL：http://www.clinicaltrials.gov。唯一标识符：NCT 02132026。
Supplemental Digital Content is available in the text. 18F-Fluoride positron emission tomography (PET) and computed tomography (CT) can measure disease activity and progression in aortic stenosis. Our objectives were to optimize the methodology, analysis, and scan–rescan reproducibility of aortic valve 18F-fluoride PET-CT imaging. Fifteen patients with aortic stenosis underwent repeated 18F-fluoride PET-CT. We compared nongated PET and noncontrast CT, with a modified approach that incorporated contrast CT and ECG-gated PET. We explored a range of image analysis techniques, including estimation of blood-pool activity at differing vascular sites and a most diseased segment approach. Contrast-enhanced ECG-gated PET-CT permitted localization of 18F-fluoride uptake to individual valve leaflets. Uptake was most commonly observed at sites of maximal mechanical stress: the leaflet tips and the commissures. Scan–rescan reproducibility was markedly improved using enhanced analysis techniques leading to a reduction in percentage error from ±63% to ±10% (tissue to background ratio MDS mean of 1.55, bias −0.05, limits of agreement −0·20 to +0·11). Optimized 18F-fluoride PET-CT allows reproducible localization of calcification activity to different regions of the aortic valve leaflet and commonly to areas of increased mechanical stress. This technique holds major promise in improving our understanding of the pathophysiology of aortic stenosis and as a biomarker end point in clinical trials of novel therapies. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02132026.