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05.08.2019 | Original Article | Ausgabe 12/2019

European Journal of Nuclear Medicine and Molecular Imaging 12/2019

Triple-gated motion and blood pool clearance corrections improve reproducibility of coronary 18F-NaF PET

Zeitschrift:
European Journal of Nuclear Medicine and Molecular Imaging > Ausgabe 12/2019
Autoren:
Martin Lyngby Lassen, Jacek Kwiecinski, Damini Dey, Sebastien Cadet, Guido Germano, Daniel S. Berman, Philip D. Adamson, Alastair J. Moss, Marc R. Dweck, David E. Newby, Piotr J. Slomka
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00259-019-04437-x) contains supplementary material, which is available to authorized users.
This article is part of the Topical Collection on Cardiology

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Abstract

Purpose

To improve the test–retest reproducibility of coronary plaque 18F-sodium fluoride (18F-NaF) positron emission tomography (PET) uptake measurements.

Methods

We recruited 20 patients with coronary artery disease who underwent repeated hybrid PET/CT angiography (CTA) imaging within 3 weeks. All patients had 30-min PET acquisition and CTA during a single imaging session. Five PET image-sets with progressive motion correction were reconstructed: (i) a static dataset (no-MC), (ii) end-diastolic PET (standard), (iii) cardiac motion corrected (MC), (iv) combined cardiac and gross patient motion corrected (2 × MC) and, (v) cardiorespiratory and gross patient motion corrected (3 × MC). In addition to motion correction, all datasets were corrected for variations in the background activities which are introduced by variations in the injection-to-scan delays (background blood pool clearance correction, BC). Test–retest reproducibility of PET target-to-background ratio (TBR) was assessed by Bland–Altman analysis and coefficient of reproducibility.

Results

A total of 47 unique coronary lesions were identified on CTA. Motion correction in combination with BC improved the PET TBR test–retest reproducibility for all lesions (coefficient of reproducibility: standard = 0.437, no-MC = 0.345 (27% improvement), standard + BC = 0.365 (20% improvement), no-MC + BC = 0.341 (27% improvement), MC + BC = 0.288 (52% improvement), 2 × MC + BC = 0.278 (57% improvement) and 3 × C + BC = 0.254 (72% improvement), all p < 0.001). Importantly, in a sub-analysis of 18F-NaF-avid lesions with gross patient motion > 10 mm following corrections, reproducibility was improved by 133% (coefficient of reproducibility: standard = 0.745, 3 × MC = 0.320).

Conclusion

Joint corrections for cardiac, respiratory, and gross patient motion in combination with background blood pool corrections markedly improve test–retest reproducibility of coronary 18F-NaF PET.

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