Abstract
BackgroundPET quantitative myocardial perfusion requires correction for partial volume loss due to one-dimensional LV wall thickness smaller than scanner resolution. MethodsWe aimed to assess accuracy of risk stratification for death, MI, or revascularization after PET using partial volume corrections derived from two-dimensional ACR and three-dimensional NEMA phantoms for 3987 diagnostic rest–stress perfusion PETs and 187 MACE events. NEMA, ACR, and Tree phantoms were imaged with Rb-82 or F-18 for size-dependent partial volume loss. Perfusion and Coronary Flow Capacity were recalculated using different ACR- and NEMA-derived partial volume corrections compared by Kolmogorov–Smirnov statistics to standard perfusion metrics with established correlations with MACE. ResultsPartial volume corrections based on two-dimensional ACR rods (two equal radii) and three-dimensional NEMA spheres (three equal radii) over estimate partial volume corrections, quantitative perfusion, and Coronary Flow Capacity by 50% to 150% over perfusion metrics with one-dimensional partial volume correction, thereby substantially impairing correct risk stratification. ConclusionsACR (2-dimensional) and NEMA (3-dimensional) phantoms overestimate partial volume corrections for 1-dimensional LV wall thickness and myocardial perfusion that are corrected with a simple equation that correlates with MACE for optimal risk stratification applicable to most PET-CT scanners for quantifying myocardial perfusion.
Highlights
Quantitative myocardial perfusion by positron emission tomography (PET) requires correction for partial volume (PV) loss due to left ventricular (LV) wall thickness being smaller than scanner resolution
American College of Radiology (ACR) (2-dimensional) and National Electrical Manufacturers Association (NEMA) (3-dimensional) phantoms overestimate partial volume corrections for 1-dimensional LV wall thickness and myocardial perfusion that are corrected with a simple equation that correlates with MACE for optimal risk stratification applicable to most PET-CT scanners for quantifying myocardial perfusion. (J Nucl Cardiol 2020;27:386–96.)
In order to show their clinical importance, we address the effects on quantitative perfusion and MACE of various PV corrections derived from the one-dimensional tree phantom branches, the two-dimensional ACR rods, and the three-dimensional NEMA spheres
Summary
Quantitative myocardial perfusion by positron emission tomography (PET) requires correction for partial volume (PV) loss due to left ventricular (LV) wall thickness being smaller than scanner resolution. A validated ‘‘simple’’ or ‘‘retention’’ perfusion model uses a fixed arterial phase image (2 minutes for Rb-82) followed by a fixed myocardial phase acquisition (5 minutes for Rb-82)[3,4,5,6,7,8,9,10,11,12,13] validated experimentally[3] as equivalent to fitting time activity curves of a compartmental model for quantitative perfusion and applied clinically (2–16). PET quantitative myocardial perfusion requires correction for partial volume loss due to one-dimensional LV wall thickness smaller than scanner resolution
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