HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH RSS TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Frouin, F. Articles by Todd-Pokropek, A. Search for Related Content PubMed PubMed Citation Articles by Frouin, F. Articles by Todd-Pokropek, A.

Validation of Myocardial Perfusion Reserve Measurements Using Regularized Factor Images of H₂¹⁵O Dynamic PET Scans

Unité 494, Imagerie Médicale Quantitative, Institut National de la Santé et de la Recherche Médicale, Paris; Service Hospitalier Frédéric Joliot, Département de Recherche Médicale, Direction des Sciences du Vivant, Commissariat à l’Energie Atomique, Orsay; Services de Cardiologie et de Médecine Nucléaire, Centre Hospitalo-Universitaire Henri Mondor, Université Paris XII, Créteil, France; and Department of Medical Physics and Bioengineering, University College London, London, England

The use of H₂¹⁵O PET scans for the measurement of myocardial perfusion reserve (MPR) has been validated in both animal models and humans. Nevertheless, this protocol requires cumbersome acquisitions such as C¹⁵O inhalation or ¹⁸F-FDG injection to obtain images suitable for determining myocardial regions of interest. Regularized factor analysis is an alternative method proposed to define myocardial contours directly from H₂¹⁵O studies without any C¹⁵O or FDG scan. The study validates this method by comparing the MPR obtained by the regularized factor analysis with the coronary flow reserve (CFR) obtained by intracoronary Doppler as well as with the MPR obtained by an FDG acquisition. Methods: Ten healthy volunteers and 10 patients with ischemic cardiopathy or idiopathic dilated cardiomyopathy were investigated. The CFR of patients was measured sonographically using a Doppler catheter tip placed into the proximal left anterior descending artery. The mean velocity was recorded at baseline and after dipyridamole administration. All subjects underwent PET imaging, including 2 H₂¹⁵O myocardial perfusion studies at baseline and after dipyridamole infusion, followed by an FDG acquisition. Dynamic H₂¹⁵O scans were processed by regularized factor analysis. Left ventricular cavity and anteroseptal myocardial regions of interest were drawn independently on regularized factor images and on FDG images. Myocardial blood flow (MBF) and MPR were estimated by fitting the H₂¹⁵O time–activity curves with a compartmental model. Results: In patients, no significant difference was observed among the 3 methods of measurement—Doppler CFR, 1.73 ± 0.57; regularized factor analysis MPR, 1.71 ± 0.68; FDG MPR, 1.83 ± 0.49—using a Friedman 2-way ANOVA by ranks. MPR measured with the regularized factor images correlated significantly with CFR (y = 1.17x - 0.30; r = 0.97). In the global population, the regularized factor analysis MPR and FDG MPR correlated strongly (y = 0.99x; r = 0.93). Interoperator repeatability on regularized factor images was 0.126 mL/min/g for rest MBF, 0.38 mL/min/g for stress MBF, and 0.34 for MPR (19% of mean MPR). Conclusion: Regularized factor analysis provides well-defined myocardial images from H₂¹⁵O dynamic scans, permitting an accurate and simple measurement of MPR. The method reduces exposure to radiation and examination time and lowers the cost of MPR protocols using a PET scanner.

Key Words: coronary flow reserve • factor analysis • regularization • H₂¹⁵O PET scans • coronary artery disease • idiopathic dilated cardiomyopathy

This article has been cited by other articles:

				A. Cassar, P. Chareonthaitawee, C. S. Rihal, A. Prasad, R. J. Lennon, L. O. Lerman, and A. Lerman Lack of Correlation Between Noninvasive Stress Tests and Invasive Coronary Vasomotor Dysfunction in Patients With Nonobstructive Coronary Artery Disease Circ Cardiovasc Interv, June 1, 2009; 2(3): 237 - 244. [Abstract] [Full Text] [PDF]

				T. O. Kiviniemi, A. Snapir, M. Saraste, J. O. Toikka, O. T. Raitakari, M. Ahotupa, J. J. Hartiala, M. Scheinin, and J. W. Koskenvuo Determinants of coronary flow velocity reserve in healthy young men Am J Physiol Heart Circ Physiol, August 1, 2006; 291(2): H564 - H569. [Abstract] [Full Text] [PDF]

				J. S. Lee, D. S. Lee, J. Y. Ahn, J. S. Yeo, G. J. Cheon, S.-K. Kim, K. S. Park, J.-K. Chung, and M. C. Lee Generation of Parametric Image of Regional Myocardial Blood Flow Using H215O Dynamic PET and a Linear Least-Squares Method J. Nucl. Med., October 1, 2005; 46(10): 1687 - 1695. [Abstract] [Full Text] [PDF]

				A. A. Lammertsma Myocardial Perfusion in 3 Dimensions J. Nucl. Med., August 1, 2002; 43(8): 1041 - 1043. [Full Text] [PDF]