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Published in: European Journal of Nuclear Medicine and Molecular Imaging 8/2012

Open Access 01-08-2012 | Original Article

Parametric imaging of myocardial viability using 15O-labelled water and PET/CT: comparison with late gadolinium-enhanced CMR

Authors: Stefan de Haan, Hendrik J. Harms, Mark Lubberink, Cornelis P. Allaart, Ibrahim Danad, Weena J. Y. Chen, Michaela Diamant, Albert C. van Rossum, Hidehiro Iida, Adriaan A. Lammertsma, Paul Knaapen

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 8/2012

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Abstract

Purpose

The perfusable tissue index (PTI) is a marker of myocardial viability. Recent technological advances have made it possible to generate parametric PTI images from a single [15O]H2O PET/CT scan. The purpose of this study was to validate these parametric PTI images.

Methods

The study population comprised 46 patients with documented or suspected coronary artery disease who were studied with [15O]H2O PET and late gadolinium-enhanced (LGE) cardiac magnetic resonance imaging (CMR).

Results

Of the 736 myocardial segments included, 364 showed some degree of LGE. PTI and perfusable tissue fraction (PTF) diminished with increasing LGE. The areas under the curve of the PTI and PTF, used to predict (near) transmural LGE on CMR, were 0.86 and 0.87, respectively. Optimal sensitivity and specificity were 91 % and 73 % for PTI and 69 % and 87 % for PTF, respectively.

Conclusion

PTI and PTF assessed with a single [15O]H2O scan can be utilized as markers of myocardial viability in patients with coronary artery disease.
Literature
2.
go back to reference Yamamoto Y, de Silva R, Rhodes CG, Araujo LI, Iida H, Rechavia E, et al. A new strategy for the assessment of viable myocardium and regional myocardial blood flow using 15O-water and dynamic positron emission tomography. Circulation. 1992;86:167–78.PubMedCrossRef Yamamoto Y, de Silva R, Rhodes CG, Araujo LI, Iida H, Rechavia E, et al. A new strategy for the assessment of viable myocardium and regional myocardial blood flow using 15O-water and dynamic positron emission tomography. Circulation. 1992;86:167–78.PubMedCrossRef
3.
go back to reference de Silva R, Yamamoto Y, Rhodes CG, Iida H, Nihoyannopoulos P, Davies GJ, et al. Preoperative prediction of the outcome of coronary revascularization using positron emission tomography. Circulation. 1992;86:1738–42.PubMedCrossRef de Silva R, Yamamoto Y, Rhodes CG, Iida H, Nihoyannopoulos P, Davies GJ, et al. Preoperative prediction of the outcome of coronary revascularization using positron emission tomography. Circulation. 1992;86:1738–42.PubMedCrossRef
4.
go back to reference Iida H, Tamura Y, Kitamura K, Bloomfield PM, Eberl S, Ono Y. Histochemical correlates of (15)O-water-perfusable tissue fraction in experimental canine studies of old myocardial infarction. J Nucl Med. 2000;41:1737–45.PubMed Iida H, Tamura Y, Kitamura K, Bloomfield PM, Eberl S, Ono Y. Histochemical correlates of (15)O-water-perfusable tissue fraction in experimental canine studies of old myocardial infarction. J Nucl Med. 2000;41:1737–45.PubMed
5.
go back to reference Itoh H, Namura M, Seki H, Asai T, Tsuchiya T, Uenishi H, et al. Perfusable tissue index obtained by positron emission tomography as a marker of myocardial viability in patients with ischemic ventricular dysfunction. Circ J. 2002;66:341–4.PubMedCrossRef Itoh H, Namura M, Seki H, Asai T, Tsuchiya T, Uenishi H, et al. Perfusable tissue index obtained by positron emission tomography as a marker of myocardial viability in patients with ischemic ventricular dysfunction. Circ J. 2002;66:341–4.PubMedCrossRef
6.
go back to reference Knaapen P, Boellaard R, Götte MJ, van der Weerdt AP, Visser CA, Lammertsma AA, et al. The perfusable tissue index: a marker of myocardial viability. J Nucl Cardiol. 2003;10:684–91.PubMedCrossRef Knaapen P, Boellaard R, Götte MJ, van der Weerdt AP, Visser CA, Lammertsma AA, et al. The perfusable tissue index: a marker of myocardial viability. J Nucl Cardiol. 2003;10:684–91.PubMedCrossRef
7.
go back to reference Knaapen P, Bondarenko O, Beek AM, Götte MJ, Boellaard R, van der Weerdt AP, et al. Impact of scar on water-perfusable tissue index in chronic ischemic heart disease: evaluation with PET and contrast-enhanced MRI. Mol Imaging Biol. 2006;8:245–51.PubMedCrossRef Knaapen P, Bondarenko O, Beek AM, Götte MJ, Boellaard R, van der Weerdt AP, et al. Impact of scar on water-perfusable tissue index in chronic ischemic heart disease: evaluation with PET and contrast-enhanced MRI. Mol Imaging Biol. 2006;8:245–51.PubMedCrossRef
8.
go back to reference Harms HJ, de Haan S, Knaapen P, Allaart CP, Lammertsma AA, Lubberink M. Parametric images of myocardial viability using a single 15O-H2O PET/CT scan. J Nucl Med. 2011;52:745–9.PubMedCrossRef Harms HJ, de Haan S, Knaapen P, Allaart CP, Lammertsma AA, Lubberink M. Parametric images of myocardial viability using a single 15O-H2O PET/CT scan. J Nucl Med. 2011;52:745–9.PubMedCrossRef
9.
go back to reference Kajander S, Joutsiniemi E, Saraste M, Pietilä M, Ukkonen H, Saraste A, et al. Cardiac positron emission tomography/computed tomography imaging accurately detects anatomically and functionally significant coronary artery disease. Circulation. 2010;122:603–13.PubMedCrossRef Kajander S, Joutsiniemi E, Saraste M, Pietilä M, Ukkonen H, Saraste A, et al. Cardiac positron emission tomography/computed tomography imaging accurately detects anatomically and functionally significant coronary artery disease. Circulation. 2010;122:603–13.PubMedCrossRef
10.
go back to reference Knaapen P, de Haan S, Hoekstra OS, Halbmeijer R, Appelman YE, Groothuis JG, et al. Cardiac PET-CT: advanced hybrid imaging for the detection of coronary artery disease. Neth Heart J. 2010;18:90–8.PubMedCrossRef Knaapen P, de Haan S, Hoekstra OS, Halbmeijer R, Appelman YE, Groothuis JG, et al. Cardiac PET-CT: advanced hybrid imaging for the detection of coronary artery disease. Neth Heart J. 2010;18:90–8.PubMedCrossRef
11.
go back to reference Boellaard R, Knaapen P, Rijbroek A, Luurtsema GJ, Lammertsma AA. Evaluation of basis function and linear least squares methods for generating parametric blood flow images using 15O-water and positron emission tomography. Mol Imaging Biol. 2005;7:273–85.PubMedCrossRef Boellaard R, Knaapen P, Rijbroek A, Luurtsema GJ, Lammertsma AA. Evaluation of basis function and linear least squares methods for generating parametric blood flow images using 15O-water and positron emission tomography. Mol Imaging Biol. 2005;7:273–85.PubMedCrossRef
12.
go back to reference Harms HJ, Knaapen P, de Haan S, Halbmeijer R, Lammertsma AA, Lubberink M. Automatic generation of absolute myocardial blood flow images using [(15)O]H(2)O and a clinical PET/CT scanner. Eur J Nucl Med Mol Imaging. 2011;38:930–9.PubMedCrossRef Harms HJ, Knaapen P, de Haan S, Halbmeijer R, Lammertsma AA, Lubberink M. Automatic generation of absolute myocardial blood flow images using [(15)O]H(2)O and a clinical PET/CT scanner. Eur J Nucl Med Mol Imaging. 2011;38:930–9.PubMedCrossRef
13.
go back to reference Watabe H, Jino H, Kawachi N, Teramoto N, Hayashi T, Ohta Y, et al. Parametric imaging of myocardial blood flow with 15O-water and PET using the basis function method. J Nucl Med. 2005;46:1219–24.PubMed Watabe H, Jino H, Kawachi N, Teramoto N, Hayashi T, Ohta Y, et al. Parametric imaging of myocardial blood flow with 15O-water and PET using the basis function method. J Nucl Med. 2005;46:1219–24.PubMed
14.
go back to reference Hermansen F, Rosen SD, Fath-Ordoubadi F, Kooner JS, Clark JC, Camici PG, et al. Measurement of myocardial blood flow with oxygen-15 labelled water: comparison of different administration protocols. Eur J Nucl Med. 1998;25:751–9.PubMedCrossRef Hermansen F, Rosen SD, Fath-Ordoubadi F, Kooner JS, Clark JC, Camici PG, et al. Measurement of myocardial blood flow with oxygen-15 labelled water: comparison of different administration protocols. Eur J Nucl Med. 1998;25:751–9.PubMedCrossRef
15.
go back to reference Kühl HP, Lipke CS, Krombach GA, Katoh M, Battenberg TF, Nowak B, et al. Assessment of reversible myocardial dysfunction in chronic ischaemic heart disease: comparison of contrast-enhanced cardiovascular magnetic resonance and a combined positron emission tomography-single photon emission computed tomography imaging protocol. Eur Heart J. 2006;27:846–53.PubMedCrossRef Kühl HP, Lipke CS, Krombach GA, Katoh M, Battenberg TF, Nowak B, et al. Assessment of reversible myocardial dysfunction in chronic ischaemic heart disease: comparison of contrast-enhanced cardiovascular magnetic resonance and a combined positron emission tomography-single photon emission computed tomography imaging protocol. Eur Heart J. 2006;27:846–53.PubMedCrossRef
16.
go back to reference Austen WG, Edwards JE, Frye RL, Gensini GG, Gott VL, Griffith LS, et al. A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. Circulation. 1975;51:5–40.PubMedCrossRef Austen WG, Edwards JE, Frye RL, Gensini GG, Gott VL, Griffith LS, et al. A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. Circulation. 1975;51:5–40.PubMedCrossRef
17.
go back to reference Wu YW, Tadamura E, Yamamuro M, Kanao S, Marui A, Tanabara K, et al. Comparison of contrast-enhanced MRI with (18)F-FDG PET/201Tl SPECT in dysfunctional myocardium: relation to early functional outcome after surgical revascularization in chronic ischemic heart disease. J Nucl Med. 2007;48:1096–103.PubMedCrossRef Wu YW, Tadamura E, Yamamuro M, Kanao S, Marui A, Tanabara K, et al. Comparison of contrast-enhanced MRI with (18)F-FDG PET/201Tl SPECT in dysfunctional myocardium: relation to early functional outcome after surgical revascularization in chronic ischemic heart disease. J Nucl Med. 2007;48:1096–103.PubMedCrossRef
18.
go back to reference Bol A, Melin JA, Vanoverschelde JL, Baudhuin T, Vogelaers D, De Pauw M, et al. Direct comparison of [13N]ammonia and [15O]water estimates of perfusion with quantification of regional myocardial blood flow by microspheres. Circulation. 1993;87:512–25.PubMedCrossRef Bol A, Melin JA, Vanoverschelde JL, Baudhuin T, Vogelaers D, De Pauw M, et al. Direct comparison of [13N]ammonia and [15O]water estimates of perfusion with quantification of regional myocardial blood flow by microspheres. Circulation. 1993;87:512–25.PubMedCrossRef
19.
go back to reference Iida H, Kanno I, Takahashi A, Miura S, Murakami M, Takahashi K, et al. Measurement of absolute myocardial blood flow with H215O and dynamic positron-emission tomography. Strategy for quantification in relation to the partial-volume effect. Circulation. 1988;78:104–15.PubMedCrossRef Iida H, Kanno I, Takahashi A, Miura S, Murakami M, Takahashi K, et al. Measurement of absolute myocardial blood flow with H215O and dynamic positron-emission tomography. Strategy for quantification in relation to the partial-volume effect. Circulation. 1988;78:104–15.PubMedCrossRef
20.
go back to reference Teramoto N, Koshino K, Yokoyama I, Miyagawa S, Zeniya T, Hirano Y, et al. Experimental pig model of old myocardial infarction with long survival leading to chronic left ventricular dysfunction and remodeling as evaluated by PET. J Nucl Med. 2011;52:761–8.PubMedCrossRef Teramoto N, Koshino K, Yokoyama I, Miyagawa S, Zeniya T, Hirano Y, et al. Experimental pig model of old myocardial infarction with long survival leading to chronic left ventricular dysfunction and remodeling as evaluated by PET. J Nucl Med. 2011;52:761–8.PubMedCrossRef
21.
go back to reference Knaapen P, Götte MJ, Paulus WJ, Zwanenburg JJ, Dijkmans PA, Boellaard R, et al. Does myocardial fibrosis hinder contractile function and perfusion in idiopathic dilated cardiomyopathy? PET and MR imaging study. Radiology. 2006;240:380–8.PubMedCrossRef Knaapen P, Götte MJ, Paulus WJ, Zwanenburg JJ, Dijkmans PA, Boellaard R, et al. Does myocardial fibrosis hinder contractile function and perfusion in idiopathic dilated cardiomyopathy? PET and MR imaging study. Radiology. 2006;240:380–8.PubMedCrossRef
22.
go back to reference Iles L, Pfluger H, Phrommintikul A, Cherayath J, Aksit P, Gupta SN, et al. Evaluation of diffuse myocardial fibrosis in heart failure with cardiac magnetic resonance contrast-enhanced T1 mapping. J Am Coll Cardiol. 2008;52:1574–80.PubMedCrossRef Iles L, Pfluger H, Phrommintikul A, Cherayath J, Aksit P, Gupta SN, et al. Evaluation of diffuse myocardial fibrosis in heart failure with cardiac magnetic resonance contrast-enhanced T1 mapping. J Am Coll Cardiol. 2008;52:1574–80.PubMedCrossRef
Metadata
Title
Parametric imaging of myocardial viability using 15O-labelled water and PET/CT: comparison with late gadolinium-enhanced CMR
Authors
Stefan de Haan
Hendrik J. Harms
Mark Lubberink
Cornelis P. Allaart
Ibrahim Danad
Weena J. Y. Chen
Michaela Diamant
Albert C. van Rossum
Hidehiro Iida
Adriaan A. Lammertsma
Paul Knaapen
Publication date
01-08-2012
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 8/2012
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-012-2134-8

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