Measurement of absolute myocardial blood flow in humans using dynamic cardiac SPECT and 99m Tc-tetrofosmin: Method and validation.

Autor: Shrestha U; Department of Radiology and Biomedical Imaging, University of California, 185 Berry St., Suite 350, San Francisco, CA, 94143-0946, USA. uttam.shrestha@ucsf.edu.; Division of Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA. uttam.shrestha@ucsf.edu., Sciammarella M; Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, USA., Alhassen F; Department of Radiology and Biomedical Imaging, University of California, 185 Berry St., Suite 350, San Francisco, CA, 94143-0946, USA., Yeghiazarians Y; Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, USA., Ellin J; Department of Radiology and Biomedical Imaging, University of California, 185 Berry St., Suite 350, San Francisco, CA, 94143-0946, USA., Verdin E; Department of Radiology and Biomedical Imaging, University of California, 185 Berry St., Suite 350, San Francisco, CA, 94143-0946, USA., Boyle A; Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, USA.; School of Medicine and Public Health, University of Newcastle, Newcastle, Australia., Seo Y; Department of Radiology and Biomedical Imaging, University of California, 185 Berry St., Suite 350, San Francisco, CA, 94143-0946, USA.; Division of Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA., Botvinick EH; Department of Radiology and Biomedical Imaging, University of California, 185 Berry St., Suite 350, San Francisco, CA, 94143-0946, USA.; Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, USA., Gullberg GT; Department of Radiology and Biomedical Imaging, University of California, 185 Berry St., Suite 350, San Francisco, CA, 94143-0946, USA.; Division of Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA.
Jazyk: angličtina
Zdroj: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology [J Nucl Cardiol] 2017 Feb; Vol. 24 (1), pp. 268-277. Date of Electronic Publication: 2015 Dec 29.
DOI: 10.1007/s12350-015-0320-3
Abstrakt: Background: The objective of this study was to measure myocardial blood flow (MBF) in humans using 99m Tc-tetrofosmin and dynamic single-photon emission computed tomography (SPECT).
Methods: Dynamic SPECT using 99m Tc-tetrofosmin and dynamic positron emission tomography (PET) was performed on a group of 16 patients. The SPECT data were reconstructed using a 4D-spatiotemporal iterative reconstruction method. The data corresponding to 9 patients were used to determine the flow-extraction curve for 99m Tc-tefrofosmin while data from the remaining 7 patients were used for method validation. The nonlinear tracer correction parameters A and B for 99m Tc-tefrofosmin were estimated for the 9 patients by fitting the flow-extraction curve [Formula: see text] for K 1 values estimated with 99m Tc-tefrofosmin using SPECT and MBF values estimated with 13 N-NH 3 using PET. These parameters were then used to calculate MBF and coronary flow reserve (CFR) in three coronary territories (LAD, RCA, and LCX) using SPECT for an independent cohort of 7 patients. The results were then compared with that estimated with 13 N-NH 3 PET. The flow-dependent permeability surface-area product (PS) for 99m Tc-tefrofosmin was also estimated.
Results: The estimated flow-extraction parameters for 99m Tc-tefrofosmin were found to be A = 0.91 ± 0.11, B = 0.34 ± 0.20 (R 2  = 0.49). The range of MBF in LAD, RCA, and LCX was 0.44-3.81 mL/min/g. The MBF between PET and SPECT in the group of independent cohort of 7 patients showed statistically significant correlation, r = 0.71 (P < .001). However, the corresponding CFR correlation was moderate r = 0.39 yet statistically significant (P = .037). The PS for 99m Tc-tefrofosmin was (0.019 ± 0.10)*MBF + (0.32 ± 0.16).
Conclusions: Dynamic cardiac SPECT using 99m Tc-tetrofosmin and a clinical two-headed SPECT/CT scanner can be a useful tool for estimation of MBF.
Databáze: MEDLINE
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