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Usefulness of abdominal belt for restricting respiratory cardiac motion and improving image quality in myocardial perfusion PET

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

The current study evaluated the usefulness of a belt technique for restricting respiratory motion of the heart and for improving image quality of 13N-ammonia myocardial PET/CT, and it assessed the tolerability of the belt technique in the clinical setting.

Methods

Myocardial 13N-ammonia PET/CT scanning was performed in 8 volunteers on Discovery PET/CT 690 with an optical respiratory motion tracking system. Emission scans were performed with and without an abdominal belt. The amplitude of left ventricular (LV) respiratory motion was measured on respiratory-gated PET images. The degree of erroneous decreases in regional myocardial uptake was visually assessed on ungated PET images using a 5-point scale (0 = normal, 1/2/3 = mild/moderate/severe decrease, 4 = defect). The tolerability of the belt technique was evaluated in 53 patients.

Results

All subjects tolerated the belt procedure. The amplitude of the LV respiratory motion decreased significantly with the belt (8.1 ± 7.1 vs 12.1 ± 6.1 mm, P = .0078). The belt significantly improved the image quality scores in the anterior (0.29 ± 0.81 vs 0.71 ± 1.04, P = .015) and inferior (0.33 ± 0.92 vs 1.04 ± 1.04, P < .0001) wall. No adverse events related to the belt technique were observed.

Conclusions

The belt technique restricts LV respiratory motion and improves the image quality of myocardial PET/CT, and it is well tolerated by patients.

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Abbreviations

CT:

Computed tomography

LV:

Left ventricular

PET:

Positron emission tomography

SPECT:

Single-photon emission computed tomography

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Disclosure

The authors report no conflicts of interest to disclose.

Author information

Authors and Affiliations

  1. Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan

    Yasutaka Ichikawa MD, Yoya Tomita RT, Masaki Ishida MD, Shigeki Kobayashi MD, Kan Takeda MD & Hajime Sakuma MD

Authors
  1. Yasutaka Ichikawa MD
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  2. Yoya Tomita RT
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  3. Masaki Ishida MD
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  4. Shigeki Kobayashi MD
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  5. Kan Takeda MD
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  6. Hajime Sakuma MD
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Corresponding author

Correspondence to Yasutaka Ichikawa MD.

Additional information

See related editorial, doi:10.1007/s12350-016-0647-4.

Appendix

Appendix

Preliminary Assessment of Image Quality of the Second PET Scan Images

Prior to the study, a preliminary evaluation to investigate if sufficient image quality can be obtained by the second PET scan with acquisition time of 20 minutes, which was employed in the study protocol, was performed.

In this preliminary evaluation, 6 healthy volunteers (4 men, 2 women; mean age, 64 ± 2 years) who underwent 13N-ammonia myocardial perfusion PET imaging were included. The dose of 13N-ammonia and the PET scan protocol of the preliminary study were identical to those of the main study, with the exception that the abdominal belt technique was not applied during the scan. For the assessment of image quality, left ventricular (LV) short-axis ungated PET images of the first and second scans with slice thickness of 5 mm were reconstructed with CT attenuation correction. The image quality of the first and second PET scans was evaluated on a 5-point scale (score 5 = excellent image quality without erroneously decreased uptake in the myocardium, score 4 = good image quality but mild erroneously decreased uptake, score 3 = acceptable image quality with moderate erroneously decreased uptake, score 2 = insufficient image quality due to severe erroneously decreased uptake, score 1 = very poor image quality) by consensus of two experienced radiologists.

There were no significant differences in image quality between the first and second PET scan images (3.7 ± 0.8 vs 3.7 ± 0.8, P = ns).

Based on the results of this preliminary assessment, it was concluded that sufficient image quality can be obtained by the second PET scan with acquisition time of 20 minutes.

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Ichikawa, Y., Tomita, Y., Ishida, M. et al. Usefulness of abdominal belt for restricting respiratory cardiac motion and improving image quality in myocardial perfusion PET. J. Nucl. Cardiol. 25, 407–415 (2018). https://doi.org/10.1007/s12350-016-0623-z

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  • DOI: https://doi.org/10.1007/s12350-016-0623-z

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