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Image-Derived Input Functions for Determination of MRGlu in Cardiac ¹⁸F-FDG PET Scans

Department of Cardiology and PET Center, Institute for Cardiovascular Research-VU, VU Medical Center, Amsterdam, The Netherlands

View larger version (25K): [in a new window]   FIGURE 1. Example of relationship of peak activity of arterial plasma time–activity curve (AS) and all IDIF (AA, LA, LV, DA) from representative study. ROIs of 15-mm diameter were used.

View larger version (33K): [in a new window]   FIGURE 2. Example of time–activity curves from arterial blood sampler (dashed lines) and from both large and small LV and AA ROIs (solid lines). (A) AA; 5-mm ROI. (B) LV; 5-mm ROI. (C) AA; 15-mm ROI. (D) LV; 15-mm ROI. These examples show close relationship of AA time–activity curves with those of blood sampler, overestimation of FDG activity with LV time–activity curves, higher noise levels in time–activity curves from small ROIs, and higher noise levels in time–activity curves from LV compared with those from AA.

View larger version (18K): [in a new window]   FIGURE 3. Limits of agreement for compartmental (Comp) and Patlak analysis (n = 17) (23). Mean difference in MRGlu = -0.01, 2 SD = 0.01 µmol/mL/min.

View larger version (15K): [in a new window]   FIGURE 4. Ratios of MRGlu obtained with IDIF to MRGlu obtained with arterial input function (Sampler) of all patients. Because of 1 outlier, LV and DA consisted of 17 patients. Rejected ratio for LV was 1.18 and for DA was 0.66. ROIs of 15-mm diameter were used.

View larger version (42K): [in a new window]   FIGURE 5. Bland–Altman plot comparing MRGlu obtained with arterial input function and MRGlu obtained with corresponding IDIF (15-mm ROIs). Dotted line represents mean difference in MRGlu; dashed lines represent corresponding value at ±2 SD. (A) AA: mean difference = 0.01, 2 SD = 0.05 µmol/mL/min. (B) LA: mean difference = 0.06, 2 SD = 0.06 µmol/mL/min. (C) LV (n = 17); mean difference = 0.06, 2 SD = 0.07 µmol/mL/min. (D) DA (n = 17): mean difference = 0.00, 2 SD = 0.07 µmol/mL/min.

View larger version (40K): [in a new window]   FIGURE 6. Bland–Altman analysis of interobserver variation using 15-mm ROIs. Dotted line represents mean difference in MRGlu; dashed lines represent corresponding value at ±2 SD. (A) AA; mean difference = 0.00, 2 SD = 0.02 µmol/mL/min. (B) LA; mean difference = -0.01, 2 SD = 0.08 µmol/mL/min. (C) LV (n = 17); mean difference = -0.03, 2 SD = 0.08 µmol/mL/min. (D) DA; mean difference = 0.00, 2 SD = 0.04 µmol/mL/min.