Single Scan Rest/Stress Cardiac PET Imaging

单次扫描静息/应激心脏 PET 成像

• 批准号: 8217286
• 负责人: ARKADIUSZ SITEK
• 金额: $ 12.13万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-02-01 至 2012-11-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8217286
• 关键词: Address; Adenosine; Affect; Algorithms; Blood; Blood flow; Cardiac; Cardiology; Characteristics; Clinic; Clinical; Clinical Protocols; Clinical Trials; Congenital Heart Defects; Coronary; Coronary Arteriosclerosis; Data; Data Set; Defect; Detection; Development; Dose; Equilibrium; Event; Exercise; Future; Grant; Heart Diseases; Image; Imaging Techniques; Imaging technology; Injection of therapeutic agent; Kinetics; Left Ventricular Ejection Fraction; Left ventricular structure; Measurement; Medical Imaging; Methodology; Methods; Minor; Modeling; Motion; Myocardial; Myocardial Infarction; Myocardial perfusion; Myocardium; Nuclear; Patient Care; Patients; Performance; Perfusion; Phase II Clinical Trials; Positron-Emission Tomography; Process; Protocols documentation; Radiation; Randomized; Reading; Recovery; Relative (related person); Rest; Right ventricular structure; Risk; Scanning; Schedule; Series; Signal Transduction; Simulate; Stress; Subtraction Technique; Sudden Death; Techniques; Technology; Testing; Time; Tracer; Vasodilator Agents; Western World; Work; X-Ray Computed Tomography; attenuation; base; cost; data acquisition; design; detector; diagnostic accuracy; disability; human subject; improved; mortality; novel; novel strategies; public health relevance; rapid technique; response; single photon emission computed tomography; time use; transmission process

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. PUBLIC HEALTH RELEVANCE: This project describes a novel clinical protocol for imaging patients for cardiac abnormalities using Positron Emission Tomography with novel PET tracer. It increases patient throughput, reduces cost of performing rest/stress PET perfusion scans, reduces radiation dose, and improves accuracy of diagnoses of cardiac diseases.

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塞，因此人们一直致力于开发新的无创成像技术，以识别有 CAD 风险和/或其破坏性后果的患者。采用新型血流示踪剂 18F-BMS 的正电子发射断层扫描 (PET) 是使用近年来出现的门控成像技术检测和定位 CAD、量化心肌血流量以及表征室壁运动异常的最有前途的方法之一。目前使用 PET 或单光子发射计算机断层扫描 (SPECT) 进行静息/应激心肌灌注成像的方法需要在静息状态和药物或运动引起的心脏应激状态下进行单独成像。这种重复成像需要后处理静息应力图像配准，耗时、低效、对患者来说繁重，并且需要衰减校正所需的重复传输或CT扫描，这增加了对患者的辐射。在这个 R21 项目下，我们提出了一种基于双注射单扫描技术的 18F-BMS 心脏 PET 新方案，用于快速休息/应激成像。在这种方法中，仅执行一次扫描即可完成休息/压力协议。开始时，患者在休息时注射示踪剂，采集动态数据，然后在大约 5-10 分钟（待确定最佳延迟）后，用药物对患者施加压力，并在不中断扫描的情况下进行第二次示踪剂给药（压力时）。第二次注射后，继续采集数据 5-10 分钟（持续时间待优化）。使用基于新的多状态动力学隔室模型的信号分离技术，根据数据计算单独的休息和应力图像以及灌注的定量参数。所提出的多状态单扫描技术具有多个优点。由于完成休息/应激心肌研究方案所需的时间很短，它将大大增加患者的吞吐量和扫描仪利用率。由于患者不会在休息和压力研究之间移动，因此估计冠状动脉血流储备 (CFR) 所需的休息和压力图像之间的配准将会得到改善。新方法还为患者带来了减少辐射剂量的好处，因为只需要一次 X 射线 CT 扫描。所提出的信号分离算法比目前在分离休息和压力信号时使用的简单背景扣除技术更强大。尽管在这项工作中我们专注于心脏 18F-BMS，但根据本次资助开发的技术也将直接适用于其他示踪剂的心脏成像。多状态心脏 PET 成像通过提供更快、更安全、更有效的 PET 定量灌注成像方法，在改善心脏病患者护理方面具有巨大潜力。 公共健康相关性：该项目描述了一种新的临床方案，使用正电子发射断层扫描和新型 PET 示踪剂对患者进行心脏异常成像。它提高了患者吞吐量，降低了执行休息/应激 PET 灌注扫描的成本，减少了辐射剂量，并提高了心脏病诊断的准确性。