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Model-Based Analysis of Electrocardiography-Gated Cardiac ¹⁸F-FDG PET Images to Assess Left Ventricular Geometry and Contractile Function

¹ Department of Cardiology, University of Vienna, Vienna, Austria
² Department of Nuclear Medicine, University of Vienna, Vienna, Austria
³ Department of Medical Computer Sciences, University of Vienna, Vienna, Austria
⁴ Third Department of Internal Medicine, General Hospital, St. Poelten, Austria
⁵ Rudolfinerhaus, Vienna, Austria

View larger version (19K): [in a new window]   FIGURE 1. (A) Three-dimensional model of left ventricle as used for calculation of volume and mass. (B) One-dimensional model of radial tracer profile originating from center of left ventricle and extending through myocardium into background. Cb = blood-pool activity; Cg = background activity; Cm = myocardial activity; d = wall thickness; h = slice thickness; n = slice number; R = left ventricular radius; z = left ventricular long axis.

View larger version (88K): [in a new window]   FIGURE 2. Example of model-based parameter estimation of cardiac geometry. Short-axis images obtained at basal (left), midventricular (middle), and apical (right) level by MRI (first and fourth rows) and PET (second and fifth rows) for diastolic (top 3 rows) and systolic (bottom 3 rows) time points. Third and sixth rows depict short-axis views with overlay of estimated endocardial and epicardial contours.

View larger version (140K): [in a new window]   FIGURE 3. Example of model-based parameter estimation in patient with large defect in tracer uptake due to myocardial infarction: short-axis (left) and horizontal long-axis (right) images with estimated endocardial and epicardial contours (bottom row).

View larger version (17K): [in a new window]   FIGURE 4. End-systolic (ESV) and end-diastolic (EDV) volumes of left ventricle, ejection fraction (EF), and left ventricular mass (LVM) as obtained from MRI and PET (P = not statistically significant [NS], paired t test).

View larger version (40K): [in a new window]   FIGURE 5. Regression analysis and Bland-Altman plots of end-systolic (ESV) (A and C) and end-diastolic (EDV) (B and D) volumes measured by PET and MRI. Dashed lines in A and B are lines of identity (PET value = MRI value). Mean difference (M) with 95% confidence limits (± 2 SDs) in C and D are presented by solid and dashed lines, respectively.

View larger version (38K): [in a new window]   FIGURE 6. Regression analysis and Bland-Altman plots of ejection fraction (EF) (A and C) and left ventricular mass (LVM) (B and D) measured by PET and MRI. Dashed lines in A and B are lines of identity (PET value = MRI value). Mean difference (M) with 95% confidence limits (± 2 SDs) in C and D are presented by solid and dashed lines, respectively.