Single Scan Rest/Stress Cardiac PET Imaging

描述（由申请人提供）：冠状动脉疾病（CAD）是西方世界死亡和残疾的主要原因。由于CAD的信号事件通常是猝死或心肌梗死，因此大量精力集中在开发新的无创成像技术以识别处于CAD风险和/或其破坏性后果的患者。正电子发射断层扫描（PET）与新的流动示踪剂18F-BMS是最有前途的方法之一，用于检测和定位CAD，量化心肌血流量，并使用近年来出现的门控成像技术来表征室壁运动异常。目前，使用PET或单光子发射计算机断层扫描（SPECT）进行静息/负荷心肌灌注成像的方法需要在静息和药物或运动诱导的心脏应激下单独成像。这种重复成像需要后处理静息-应力图像配准，对患者来说是耗时的、低效的、繁重的，并且需要增加对患者的辐射剂量的衰减校正所需的重复传输或CT扫描。在这个R21项目中，我们提出了一种新的18F-BMS心脏PET方案，该方案基于双注射单扫描技术，用于快速静息/负荷成像。在该方法中，仅执行单次扫描以完成休息/应力协议。在开始时，患者在休息时注射示踪剂，采集动态数据，然后在约5-10分钟（待确定的最佳延迟）后，患者用药剂应激，并且在不中断扫描的情况下进行示踪剂的第二次施用（应激）。第二次注射后，数据采集继续进行5-10分钟（持续时间有待优化）。单独的休息和应力图像和定量参数的灌注计算的数据，使用信号分离技术的基础上新的多状态动力学房室模型。所提出的多状态单扫描技术提供了几个优点。由于完成静息/负荷心肌研究方案所需的时间较短，因此它将大大增加患者吞吐量和扫描仪利用率。由于患者不会在静息和负荷研究之间移动，因此可以改善静息和负荷图像之间的配准，以估计冠状动脉血流储备（CFR）。这种新方法还可以减少患者的辐射剂量，因为只需进行一次X射线CT扫描。所提出的信号分离算法是更强大的比简单的背景减法技术，目前正在使用分离休息和应力信号。虽然在这项工作中，我们专注于心脏18F-BMS，在此授权下开发的技术也将直接适用于心脏成像与其他示踪剂。多状态心脏PET成像通过提供更快、更安全和更有效的PET定量灌注成像方式，具有改善心脏病患者护理的巨大潜力。

DESCRIPTION (provided by applicant): Coronary artery disease (CAD) is the leading cause of mortality and disability in the western world. Since the signal event of CAD is often sudden death or myocardial infarction, great energy has been focused on developing new noninvasive imaging technologies to identify patients at risk for CAD and/or its devastating consequences. Positron emission tomography (PET) with the new flow tracer 18F-BMS is one of the most promising methods for detecting and localizing CAD, quantifying myocardial blood flow, and characterizing wall motion abnormalities using gated imaging techniques that have emerged in recent years. Current approaches to rest/stress myocardial perfusion imaging with either PET or Single-Photon Emission Computed Tomography (SPECT) require separate imaging at rest and under pharmacologic- or exercise-induced cardiac stress. Such repeat imaging requires post-processing rest-stress image coregistration, is time-consuming, inefficient, onerous to the patient, and requires repeated transmission or CT scans needed for attenuation correction that increase radiation does to the patient. Under this R21 project, we propose a new protocol for 18F-BMS cardiac PET based on a dual-injection single-scan technique for rapid rest/stress imaging. In this approach only a single scan is performed to complete the rest/stress protocol. At the beginning patient is injected with tracer at rest, dynamic data is acquired, and then after about 5-10 minutes (optimal delay to be determined) patient is stressed with the pharmacologic agent and a second administration of tracer (at stress) is performed without interrupting the scanning. Following the second injection, data acquisition is continued for another 5-10 minutes (duration to be optimized). Separate rest and stress images and quantitative parameters of perfusion are calculated from the data using signal separation techniques based on new multi-state kinetic compartmental models. The proposed multi-state single-scan technique offers several advantages. It would substantially increase patient throughput and scanner utilization due to the short time needed for completing the rest/stress myocardial study protocol. The coregistration between images at rest and stress needed for estimation of coronary flow reserve (CFR) would be improved because patients are not moved between rest and stress studies. The new approach also comes with benefits to the patient in reduced radiation dose because only one x-ray CT scan is necessary. The proposed signal-separation algorithms are more powerful than the simple background subtraction technique currently being employed when separating rest and stress signals. Although in this work we concentrate on cardiac 18F-BMS, the techniques developed under this grant will also be directly applicable to cardiac imaging with other tracers. Multi-state cardiac PET imaging has great potential to improve cardiac patient care by providing a faster, safer, and more effective way of performing quantitative perfusion imaging with PET.