Myocardial creep and cardiorespiratory motion correction improves diagnostic accuracy of Rubidium-82 cardiac positron emission tomography,Journal of Nuclear Cardiology

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Myocardial creep and cardiorespiratory motion correction improves diagnostic accuracy of Rubidium-82 cardiac positron emission tomography
Journal of Nuclear Cardiology ( IF 3.0 ) Pub Date : 2023-08-25 , DOI: 10.1007/s12350-023-03360-x
Martin Lyngby Lassen _{1,

2} , Thomas Rasmussen _{1,

2} , Christina Byrne _{1,

2} , Lene Holmvang ₃ , Andreas Kjaer _{1,

2} , Philip Hasbak ₁

Affiliation

Aim

To evaluate the feasibility of retrospectively detecting and correcting periodical (cardiac and respiratory motion) and non-periodical shifts of the myocardial position (myocardial creep) using only the acquired Rubidium-82 positron emission tomography raw (listmode) data.

Methods

This study comprised 25 healthy participants (median age = 23 years) who underwent repeat rest/adenosine stress Rubidium-82 myocardial perfusion imaging (MPI) and 53 patients (median age = 64 years) considered for revascularization who underwent a single MPI session. All subjects were evaluated for myocardial creep during MPI by assessing the myocardial position every 200 ms. A proposed motion correction protocol, including corrections for cardiorespiratory and creep motion (3xMC), was compared to a guideline-recommended protocol (Standard_Recon). For the volunteers, we report test-retest repeatability using standard error of measurements (SEM). For the patient cohort, we evaluated the area under the receiver operating curve (AUC) for both stress and ischemic total perfusion deficits (sTPD and iTPD, respectively) using myocardial ischemia defined as fractional flow reserve values < 0.8 in the relevant coronary segment as the gold standard.

Results

Test-retest repeatability was significantly improved following corrections for myocardial creep (SEM; sTPD: Standard_Recon = 2.2, 3xMC = 1.8; iTPD: Standard_Recon = 1.6, 3xMC = 1.2). AUC analysis of the ROC curves revealed significant improvements for iTPD measurements following 3xMC [sTPD: Standard_Recon = 0.88, 3xMC = 0.92 (P = .21); iTPD: Standard_Recon = 0.88, 3xMC = 0.95 (P = .039)].

Conclusion

3xMC has the potential to improve the diagnostic accuracy of myocardial MPI obtained from positron emission tomography. Therefore, its use should be considered both in clinical routine and large-scale multicenter studies.

中文翻译：

心肌蠕变和心肺运动校正提高了铷-82心脏正电子发射断层扫描的诊断准确性

目的

评估仅使用获得的铷-82正电子发射断层扫描原始（列表模式）数据回顾性检测和纠正心肌位置的周期性（心脏和呼吸运动）和非周期性移位（心肌蠕动）的可行性。

方法

这项研究包括 25 名接受重复休息/腺苷应激铷-82 心肌灌注成像 (MPI) 的健康参与者（中位年龄 = 23 岁）和 53 名考虑进行血运重建且接受单次 MPI 治疗的患者（中位年龄 = 64 岁）。在 MPI 期间，通过每 200 毫秒评估一次心肌位置来评估所有受试者的心肌蠕变情况。将提议的运动校正方案（包括心肺运动和蠕动运动 (3xMC) 的校正）与指南推荐的方案 (Standard _Recon ) 进行比较。对于志愿者，我们使用测量标准误差 (SEM) 报告重测重复性。对于患者队列，我们使用心肌缺血（定义为相关冠状动脉段中血流储备分数 < 0.8）来评估应激和缺血总灌注不足（分别为 sTPD 和 iTPD）的受试者工作曲线下面积 (AUC)。黄金标准。

结果

校正心肌蠕变后，重测重复性显着提高（SEM；sTPD：标准_Recon = 2.2，3xMC = 1.8；iTPD：标准_Recon = 1.6，3xMC = 1.2）。 ROC 曲线的 AUC 分析揭示了 3xMC 后 iTPD 测量的显着改善 [sTPD：标准_Recon = 0.88，3xMC = 0.92 ( P = .21)； iTPD：标准_侦察= 0.88，3xMC = 0.95 ( P = .039)]。