Abstract
We aim to facilitate phantom-based (ground truth) evaluation of dynamic, quantitative myocardial perfusion imaging (MPI) applications. Current MPI phantoms are static representations or lack clinical hard- and software evaluation capabilities. This proof-of-concept study demonstrates the design, realisation and testing of a dedicated cardiac flow phantom. The 3D printed phantom mimics flow through a left ventricular cavity (LVC) and three myocardial segments. In the accompanying fluid circuit, tap water is pumped through the LVC and thereafter partially directed to the segments using adjustable resistances. Regulation hereof mimics perfusion deficit, whereby flow sensors serve as reference standard. Seven phantom measurements were performed while varying injected activity of 99mTc-tetrofosmin (330–550 MBq), cardiac output (1.5–3.0 L/min) and myocardial segmental flows (50–150 mL/min). Image data from dynamic single photon emission computed tomography was analysed with clinical software. Derived time activity curves were reproducible, showing logical trends regarding selected input variables. A promising correlation was found between software computed myocardial flows and its reference (rho= − 0.98; p = 0.003). This proof-of-concept paper demonstrates we have successfully measured first-pass LV flow and myocardial perfusion in SPECT-MPI using a novel, dedicated, myocardial perfusion phantom.Graphical abstractThis proof-of-concept study focuses on the development of a novel, dedicated myocardial perfusion phantom, ultimately aiming to contribute to the evaluation of quantitative myocardial perfusion imaging applications.
Highlights
Absolute quantification in dynamic rest and stress myocardial perfusion imaging (MPI) is becoming more routine in the assessment of myocardial ischemia and the diagnosis of coronary artery disease [1–3]
Patients suffering from balanced ischemia, complicated previous multiple coronary interventions and microvascular dysfunction may especially benefit from measurement of myocardial blood flow (MBF) and flow reserve (MFR) [4, 5]
Quantitative MPI expands to other imaging domains, including computed tomography (CT) [8, 9], magnetic resonance imaging (MRI) [10], single photon emission CT (SPECT) [11–13] and ultrasound (US) [14]
Summary
Absolute quantification in dynamic rest and stress myocardial perfusion imaging (MPI) is becoming more routine in the assessment of myocardial ischemia and the diagnosis of coronary artery disease [1–3]. Patients suffering from balanced ischemia, complicated previous multiple coronary interventions and microvascular dysfunction may especially benefit from measurement of myocardial blood flow (MBF) and flow reserve (MFR) [4, 5]. This is in addition to visual evaluation or semi-quantitative approaches. Many studies have focused on quantitative MPI with positron emission tomography (PET) [5–7]. Quantitative MPI expands to other imaging domains, including computed tomography (CT) [8, 9], magnetic resonance imaging (MRI) [10], single photon emission CT (SPECT) [11–13] and ultrasound (US) [14].
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