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Evaluation of Pulmonary Systemic Blood Flow Using ECG Gated Acquisition

Biophysics Service, Faculty of Medicine, University of Coimbra
Department of Electronics and Telecommunications, University of Aveiro
Cardiology and Cardiothoracic Surgery Services, Hospital of the University of Coimbra, Coimbra, Portugal
Department of Radiology, Division of Nuclear Medicine, University of Washington, Seattle, Washington

Correspondence: For correspondence and reprints, contact J.J. Pedroso de Lima, Serv. de Biofisica, Fac de Medicina, 3049 Coimbra Codex, Portugal.

ABSTRACT

We propose a functional parametric analysis method using ECG-gated ^99mTc-labeled red blood cell (RBC) imaging for detection and characterization of periodic variations in local blood activity in the lungs during cardiac cycle. We validated in animal experiments that such count variations correlate with cyclical pulmonary blood flow and may be used for evaluation of systemic-to-pulmonary shunts. Clinical studies were performed in 48 patients. After labeling the ABC pool with ^99mTc, ECG-gated gamma camera images of both lung fields were acquired and processed to obtain Fourier transforms of time/activity functions in selected regions. The first harmonic parametric images of amplitude and phase were derived. There was an excellent correlation (r = 0.92) between activity variations and pulsatile flow measured by our method with that obtained by the thermodilution method in dog experiments (n = 10) after implantation of a systemic-to-pulmonary shunt. Patient studies showed the technique to be sensitive in detecting and quantifying abnormal systemic-to-pulmonary blood flow. Lung pulsatile flow can thus be noninvasively measured from functional parametric phase and amplitude images; the technique may be useful for detecting and quantifying abnormal systemic-to-pulmonary blood flow in man.