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Parametric Polar Maps of Regional Myocardial ß-Adrenoceptor Density

Department of Cardiology/Thorax Center and PET Center, Groningen University Hospital, Groningen, The Netherlands
MRC, Cyclotron Unit, Imperial College School of Medicine, Hammersmith Hospital, London, England

Correspondence: For correspondence or reprints contact: Richard M. de Jong, PhD, Department of Cardiology/Thorax Center, Groningen University Hospital, P.O. Box 30001, 9700 RB Groningen, The Netherlands.

ABSTRACT

Quantification of myocardial ß-adrenocepetor density (B_max) of interest in cardiac diseases in which altered function of the sympathetic nervous system is thought to play a pathophysiological role. PET provides an unrivaled means of taking regional measurements of cardiac microcirculatory function, tissue metabolism and autonomic nervous system activity. Measurements in small regional areas may be biased because of increased noise levels. This study examined the parametric polar map approach for the regional quantification of B_max. Methods: Dynamic PET with parametric polar map imaging was performed in 10 healthy volunteers and 4 patients with hypertrophic cardiomyopathy using (S)-[¹¹C]-(4-(3-tertiarybutylamino-2-hydroxypropoxy)-benzidimazole-2)-on hydrochloride (CGP)-12177 and a double-injection protocol. Time-activity curves were corrected for partial volume, spill-over and wall motion effects. The mean B_max of the left ventricle was calculated in two ways. First, the average time-activity curve of all segments, having the highest achievable signal-to-noise ratio, was used to calculate B_max(mTAC) (the myocardial beta-adrenoceptor density of the left ventricle calculated using the average time-activity curve). The bias in B_max(mTAC) introduced by noise is minimal. Second, an estimate of wholeheart receptor density was calculated using the polar map method by averaging the values of B_max obtained for 576 individual segments. In these calculations, three different filters (3 x 5, 3 x 9 and 3 x 13 segments) were used to smooth the time-activity curves before calculating B_max. Mean values of whole-left-ventricular receptor density obtained by averaging regional values using the different filters (B_{max(PMF1/2/3)}) were compared with B_max(mTAC) to assess bias introduced by the polar map approach. Segments with a calculated B_max outside the range 0.1–50 pmol/g were considered unreliable and were excluded from the analysis. Results: The differences between the two methods of calculating B_max were small (7.8%, 4.8% and 3.2%, with the three filters, respectively). Reliable results were obtained in >95% of the segments and in 9 volunteers and all 4 patients. Conclusion: When using PET for the quantification of ß-adrenoceptdor density, the regional variation in B_max can be reliably assessed using the parametric polar map approach.

Key Words: ß-adrenoceptor • PET • parametric imaging

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