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- Title
Pitfalls in quantitative myocardial PET perfusion II: Arterial input function.
- Authors
Bui, Linh; Kitkungvan, Danai; Roby, Amanda E.; Nguyen, Tung T.; Gould, K. Lance
- Abstract
<bold>Rationale: </bold>We aimed to define the impact of variable arterial input function on myocardial perfusion severity that may misguide interventional decisions and relates to limited capacity of 3D PET for high-count arterial input function of standard bolus R-82.<bold>Methods: </bold>We used GE Discovery-ST 16 slice PET-CT, serial 2D and 3D acquisitions of variable Rb-82 dose in a dynamic circulating arterial function model, static resolution and uniformity phantoms, and in patients with dipyridamole stress to quantify per-pixel rest and stress cc·min-1·g-1, CFR and CFC with (+) and (-) 10% simulated change in arterial input.<bold>Results: </bold>For intermediate, border zone severity of stress perfusion, CFR and CFC comprising 7% of 3987 cases, simulated arterial input variability of ± 10% may cause over or underestimation of perfusion severity altering interventional decisions. In phantom tests, current 3D PET has capacity for quantifying high activity of arterial input and high-count per-pixel values of perfusion metrics per artery or branches.<bold>Conclusions: </bold>Accurate, reproducible arterial input function is essential for at least 7% of patients at thresholds of perfusion severity for optimally guiding interventions and providing high-activity regional per-pixel perfusion metrics by 3D PET for displaying complex quantitative perfusion readily understood ("owned") by interventionalists to guide procedures.
- Subjects
PERFUSION; ISOLATION perfusion
- Publication
Journal of Nuclear Cardiology, 2020, Vol 27, Issue 2, p397
- ISSN
1071-3581
- Publication type
journal article
- DOI
10.1007/s12350-020-02074-8