High definition cardiac perfusion PET using a new F-18 imaging agent (BMS747158)

Objectives HD-PET technology improves spatial resolution and signal-to-noise on reconstructed PET images (IEEE TMI 2006:25:7:907-921) but the thermal path of the positron emitted by rubidium limits its benefits in Rb-82 perfusion images. To evaluate its full potential for high-resolution cardiac imaging, we evaluated HD-PET with myocardial perfusion images obtained with a new F-18 based agent (BMS-747158).

Methods Images of 15 patients recruited at Cedars-Sinai Medical Center as part of the Phase II clinical trial for a new F-18 perfusion agent were acquired on a 4-ring Siemens Biograph-64. Static and 8-bin ECG-gated images were generated using standard reconstruction (SR - 2D Attenuation Weighted Ordered Subsets Expectation Maximization) and HD-PET. We computed the wall/cavity contrast and contrast-to-noise ratio (CNR), and maximum to defect contrast. Wall thickness at three different levels of heart (basal, mid, apical), wall motion, wall thickening and ejection fraction (EF) were also estimated with automatic quantification.

Results HD-PET showed significant contrast change compared to SR (+32.3±17.9%, p<0.05). CNR also was improved with HD-PET (+26.7±22.3% vs SR, p<0.05). The average contrast between the maximum in the myocardium and the 22 defects in the 15 patients was increased with HD-PET (4.0±1.7) compared to SR (3.2±1.2, p<0.05). The average wall thickness was 16.3±2.9mm, 16.7±2.9mm and 15.6±2.2mm (basal, mid, apical) with SR compared with 14.7±2.8mm, 14.1±3.0mm and 13.0±1.7mm with HD-PET (p<0.05). EF, wall motion and wall thickening did not show any significant differences with HD-PET.

Conclusions Perfusion studies with a new F-18 agent show significantly improved image resolution, contrast and contrast-to-noise with HD-PET reconstruction as compared with the standard reconstruction technique