Evaluation of ECG-gated [11C]acetate PET for measuring left ventricular volumes, mass, and myocardial external efficiency
- 253 Downloads
Noninvasive estimation of myocardial external efficiency (MEE) requires measurements of left ventricular (LV) oxygen consumption with [11C]acetate PET in addition to LV stroke volume and mass with cardiovascular magnetic resonance (CMR). Measuring LV geometry directly from ECG-gated [11C]acetate PET might enable MEE evaluation from a single PET scan. Therefore, we sought to establish the accuracy of measuring LV volumes, mass, and MEE directly from ECG-gated [11C]acetate PET.
Thirty-five subjects with aortic valve stenosis underwent ECG-gated [11C]acetate PET and CMR. List mode PET data were rebinned into 16-bin ECG-gated uptake images before measuring LV volumes and mass using commercial software and compared to CMR. Dynamic datasets were used for calculation of mean LV oxygen consumption and MEE.
LV mass, volumes, and ejection fraction measured by CMR and PET correlated strongly (r = 0.86-0.92, P < .001 for all), but were underestimated by PET (P < .001 for all except ESV P = .79). PET-based MEE, corrected for bias, correlated fairly with PET/CMR-based MEE (r = 0.60, P < .001, bias −3 ± 21%, P = .56). PET-based MEE bias was strongly associated with LV wall thickness.
Although analysis-related improvements in accuracy are recommended, LV geometry estimated from ECG-gated [11C]acetate PET correlate excellently with CMR and can indeed be used to evaluate MEE.
KeywordsMyocardial external efficiency PET imaging magnetic resonance imaging metabolism: PET
Myocardial external efficiency
Cardiovascular magnetic resonance
Myocardial oxygen consumption
- LV MVO2
Left ventricle total oxygen consumption
Emory cardiac toolbox
Mean transaortic valve gradient
MEE calculated using both PET and CMR data
MEE calculated using PET data only
MEE calculated from PET data only using SV and mass corrected according to the derived linear regression equation for PET and CMR values
Work metabolic index
Authors thank cardiologist Inger Sihm at Aarhus Hjerteklinik and The Department of Cardiology at the Regional Hospital in Horsens, Denmark for assisting in subject recruitment. We also thank Anders Jorsal, Bent Roni Ranghøj Nielsen and Peter Iversen for their assistance during protocol preparation.
This study received financial assistance from the Lundbeck Foundation, Arvid Nilssons Foundation, Karen Elise Jensens Foundation and Snedkermester Sophus Jacobsen & Hustru Astrid Jacobsens Foundation. Henrik Wiggers is principal investigator in studies involving the following pharmaceutical companies; NovoNordisk, MSD, Bayer, Daiichi-Sankyo, Novartis, Sanofi-Aventis, Pfizer. For Nils Henrik Stubkjaer Hansson, Johannes Hendrik Harms, Lars Poulsen Tolbod, Won Yong Kim, Esben Sovso Szocska Hansen, Tomas Zaremba, Steen Jakobsen, Jorgen Frokiaer and Jens Sorensen, there are no disclosures.
- 7.Hata T, Nohara R, Fujita M, Hosokawa R, Lee L, Kudo T, et al. Noninvasive assessment of myocardial viability by positron emission tomography with 11C acetate in patients with old myocardial infarction usefulness of low-dose dobutamine infusion. Circulation 1996;94:1834-41.CrossRefPubMedGoogle Scholar
- 18.Knaapen P, Germans T. Myocardial efficiency in heart failure: Non invasive imaging. Heart Metab 2008;39:14.Google Scholar
- 19.Currie PJ, Seward JB, Reeder GS, Vlietstra RE, Bresnahan DR, Bresnahan JF, et al. Continuous-wave doppler echocardiographic assessment of severity of calcific aortic stenosis: A simultaneous doppler-catheter correlative study in 100 adult patients. Circulation 1985;71:1162-9.CrossRefPubMedGoogle Scholar
- 21.Schaefer WM, Lipke CS, Nowak B, Kaiser HJ, Buecker A, Krombach GA, et al. Validation of an evaluation routine for left ventricular volumes, ejection fraction and wall motion from gated cardiac FDG PET: A comparison with cardiac magnetic resonance imaging. Eur J Nucl Med Mol Imaging 2003;30:545-53.CrossRefPubMedGoogle Scholar
- 25.Wei H, Tian C, Schindler TH, Qiu M, Lu M, Shen R, et al. The impacts of severe perfusion defects, akinetic/dyskinetic segments, and viable myocardium on the accuracy of volumes and LVEF measured by gated (9)(9)mTc-MIBI SPECT and gated (1)(8)F-FDG PET in patients with left ventricular aneurysm: Cardiac magnetic resonance imaging as the reference. J Nucl Cardiol 2014;21:1230-44.CrossRefPubMedGoogle Scholar
- 26.Hofman HA, Knaapen P, Boellaard R, Bondarenko O, Gotte MJ, van Dockum WG, et al. Measurement of left ventricular volumes and function with O-15-labeled carbon monoxide gated positron emission tomography: Comparison with magnetic resonance imaging. J Nucl Cardiol 2005;12:639-44.CrossRefPubMedGoogle Scholar
- 28.Schulz-Menger J, Bluemke DA, Bremerich J, Flamm SD, Fogel MA, Friedrich MG, et al. Standardized image interpretation and post processing in cardiovascular magnetic resonance: Society for cardiovascular magnetic resonance (SCMR) board of trustees task force on standardized post processing. J Cardiovasc Magn Reson 2013;15:35.CrossRefPubMedPubMedCentralGoogle Scholar
- 30.Grothues F, Smith GC, Moon JC, Bellenger NG, Collins P, Klein HU, et al. Comparison of interstudy reproducibility of cardiovascular magnetic resonance with two-dimensional echocardiography in normal subjects and in patients with heart failure or left ventricular hypertrophy. Am J Cardiol 2002;90:29-34.CrossRefPubMedGoogle Scholar
- 31.Beanlands RS, Armstrong WF, Hicks RJ, Nicklas J, Moore C, Hutchins GD, et al. The effects of afterload reduction on myocardial carbon 11-labeled acetate kinetics and noninvasively estimated mechanical efficiency in patients with dilated cardiomyopathy. J Nucl Cardiol 1994;1:3-16.CrossRefPubMedGoogle Scholar