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Analytical quantification of aortic valve 18F-sodium fluoride PET uptake

  • Original Article
  • Published:
Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Challenges to cardiac PET-CT include patient motion, prolonged image acquisition and a reduction of counts due to gating. We compared two analytical tools, FusionQuant and OsiriX, for quantification of gated cardiac 18F-sodium fluoride (18F-fluoride) PET-CT imaging.

Methods

Twenty-seven patients with aortic stenosis were included, 15 of whom underwent repeated imaging 4 weeks apart. Agreement between analytical tools and scan-rescan reproducibility was determined using the Bland–Altman method and Lin’s concordance correlation coefficients (CCC).

Results

Image analysis was faster with FusionQuant [median time (IQR) 7:10 (6:40-8:20) minutes] compared with OsiriX [8:30 (8:00-10:10) minutes, p = .002]. Agreement of uptake measurements between programs was excellent, CCC = 0.972 (95% CI 0.949-0.995) for mean tissue-to-background ratio (TBRmean) and 0.981 (95% CI 0.965-0.997) for maximum tissue-to-background ratio (TBRmax). Mean noise decreased from 11.7% in the diastolic gate to 6.7% in motion-corrected images (p = .002); SNR increased from 25.41 to 41.13 (p = .0001). Aortic valve scan-rescan reproducibility for TBRmax was improved with FusionQuant using motion correction compared to OsiriX (error ± 36% vs ± 13%, p < .001) while reproducibility for TBRmean was similar (± 10% vs ± 8% p = .252).

Conclusion

18F-fluoride PET quantification with FusionQuant and OsiriX is comparable. FusionQuant with motion correction offers advantages with respect to analysis time and reproducibility of TBRmax values.

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Abbreviations

PET:

Positron emission tomography

CT:

Computed tomography

ECG:

Electrocardiogram

ROI:

Region of interest

SNR:

Signal-to-noise ratio

TBR:

Tissue-to-background ratio

SUV:

Standardized uptake value

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Disclosure

The authors have indicated that they have no financial conflict of interest.

Author information

Authors and Affiliations

  1. Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, NY, USA

    Daniele Massera MD, MSc

  2. BHF Centre for Cardiovascular Science, Clinical Research Imaging Centre, Edinburgh Heart Centre, University of Edinburgh, Edinburgh, Scotland, UK

    Mhairi K. Doris MD, Jacek Kwiecinski MD, Tania A. Pawade MD, PhD, David E. Newby MD, PhD & Marc R. Dweck MD, PhD

  3. Department of Imaging, Medicine and Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Ste A047 N, Los Angeles, CA, 90048, USA

    Sebastien Cadet MSc, Jacek Kwiecinski MD, Damini Dey PhD & Piotr J. Slomka PhD

  4. Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands

    Frederique E. C. M. Peeters MD

Authors
  1. Daniele Massera MD, MSc
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  2. Mhairi K. Doris MD
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  3. Sebastien Cadet MSc
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  4. Jacek Kwiecinski MD
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  9. Marc R. Dweck MD, PhD
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Contributions

DM, MKD, JK, DD, DEN, MRD, and PJS participated in conception and design of the study; DM, MKD, SC, JK, TAP, and FECMP were actively involved in collecting data and data analysis; DM, MRK, and PJS drafted the manuscript; all authors gave final approval of the submitted manuscript.

Corresponding author

Correspondence to Piotr J. Slomka PhD.

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The authors of this article have provided a PowerPoint file, available for download at SpringerLink, which summarises the contents of the paper and is free for re-use at meetings and presentations. Search for the article DOI on SpringerLink.com.

Funding

This research was supported in part by Grant R01HL135557 from the National Heart, Lung, and Blood Institute/National Institute of Health (NHLBI/NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. D. M. was supported by The Glorney-Raisbeck Fellowship Program, Corlette Glorney Foundation, and The New York Academy of Medicine. The study was also supported by a Grant (“Cardiac Imaging Research Initiative”) from the Miriam & Sheldon G. Adelson Medical Research Foundation. David Newby (CH/09/002, RE/13/3/30183), Marc Dweck (FS/14/78), and Mhairi Doris (FS/17/79/33226) are supported by the British Heart Foundation. David Newby is also the recipient of a Wellcome Trust Senior Investigator Award (WT103782AIA). Marc Dweck is the recipient of the Sir Jules Thorn Award for biomedical research (15/JTA).

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Massera, D., Doris, M.K., Cadet, S. et al. Analytical quantification of aortic valve 18F-sodium fluoride PET uptake. J. Nucl. Cardiol. 27, 962–972 (2020). https://doi.org/10.1007/s12350-018-01542-6

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  • DOI: https://doi.org/10.1007/s12350-018-01542-6

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