TY - JOUR T1 - Reproducibility and repeatability of cardiac <sup>11</sup>C-Hydroxyephedrine PET sympathetic nervous system imaging and kinetics JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 232 LP - 232 VL - 59 IS - supplement 1 AU - Kai Yi Wu AU - Tong Wang AU - Vincent Dinculescu AU - Robert Miner AU - Jennifer Renaud AU - Lisa Marie Mielniczuk AU - Rob Beanlands AU - Robert DeKemp Y1 - 2018/05/01 UR - http://jnm.snmjournals.org/content/59/supplement_1/232.abstract N2 - 232Objectives: Dysfunction in the cardiac sympathetic nervous system (SNS) has been associated with poor prognosis in patients with chronic heart failure. The purpose of this study was to characterize the reproducibility and repeatability of [11C]-meta-hydroxyephedrine (HED) PET imaging of cardiac SNS function. Methods: Dynamic 11C-HED PET/CT scans were performed 47±22 days apart at baseline and followup in 20 heart failure with reduced ejection fraction patients. Three observers blinded to patients’ clinical data used FlowQuant to evaluate the intra- and inter-observer reproducibility and test-retest repeatability of 11C-HED tracer uptake and clearance rates to measure volume of distribution (DV), myocardial blood flow (MBF), and retention index (RI). Since sympathetic denervation assessed using 11C-HED PET has been shown to be a predictor of sudden cardiac death, regional % defects of K1, k2, and retention were assessed by the proportion of values &lt;75% of the peak value in the LV. Both global and regional partial-volume corrections were performed. Reproducibility and repeatability were evaluated using intra-class-correlation (ICC) and Bland-Altman parametric and non-parametric coefficient-of-repeatability (NPC and RPC, respectively). Results: All intra- and inter-observer correlations were excellent (ICC&gt;0.89) and reproducibility values (NPC = 6-13%) were significantly lower than the test-retest values (NPC =11-48%). RI and % defect RI (NPC = 29% and 11%) exhibited the best test-retest repeatability compared to similar measures of DV and % defect DV (NPC = 17-48%). Global partial-volume corrected DV values (NPC = 17-44%) consistently showed improved repeatability over regionally corrected DV (NPC =21-48%). MBF exhibited the greatest test-retest repeatability of 59%. Conclusion: 11C-HED PET analysis can be performed reliably by different operators using a highly-automated program. Measures of global and regional SNS function were more repeatable using the retention index compared to distribution volume tracer kinetic model. ER -