Journal of Nuclear Cardiology

, Volume 25, Issue 6, pp 1929–1936 | Cite as

Test–retest repeatability of myocardial oxidative metabolism and efficiency using standalone dynamic 11C-acetate PET and multimodality approaches in healthy controls

  • Nils Henrik HanssonEmail author
  • Hendrik Johannes Harms
  • Won Yong Kim
  • Roni Nielsen
  • Lars P. Tolbod
  • Jørgen Frøkiær
  • Kirsten Bouchelouche
  • Steen Hvitfeldt Poulsen
  • Henrik Wiggers
  • Erik Thorlund Parner
  • Jens Sörensen
Original Article



Myocardial efficiency measured by 11C-acetate positron emission tomography (PET) has successfully been used in clinical research to quantify mechanoenergetic coupling. The objective of this study was to establish the repeatability of myocardial external efficiency (MEE) and work metabolic index (WMI) by non-invasive concepts.

Methods and Results

Ten healthy volunteers (63 ± 4 years) were examined twice, one week apart, using 11C-acetate PET, cardiovascular magnetic resonance (CMR), and echocardiography. Myocardial oxygen consumption from PET was combined with stroke work data from CMR, echocardiography, or PET to obtain MEE and WMI for each modality. Repeatability was estimated as the coefficient of variation (CV) between test and retest. MEECMR, MEEEcho, and MEEPET values were 21.9 ± 2.7%, 16.4 ± 3.7%, and 23.8 ± 4.9%, respectively, P < .001. WMICMR, WMIEcho, and WMIPET values were 4.42 ± 0.90, 4.07 ± 0.63, and 4.58 ± 1.13 mmHg × mL/m2 × 106, respectively, P = .45. Repeatability for MEECMR was superior compared with MEEEcho but did not differ significantly compared with MEEPET (6.3% vs 12.9% and 9.4%, P = .04 and .25). CV values for WMICMR, WMIEcho, and WMIPET were 10.0%, 14.8%, and 12.0%, respectively, (P = .53).


Non-invasive measurements of MEE using 11C-acetate PET are highly repeatable. A PET-only approach did not differ significantly from CMR/PET and might facilitate further clinical research due to lower costs and broader applicability.


PET MRI Echo Metabolic 



Cardiovascular magnetic resonance


Forward stroke volume


Geometrical stroke volume


Heart rate


Left ventricle


Mean arterial blood pressure


Myocardial external efficiency


Myocardial oxygen consumption


Stroke volume



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: Novo Nordisk, MSD, Bayer, Daiichi-Sankyo, Novartis, Sanofi-Aventis, and Pfizer. For Nils Henrik Hansson, Johannes Hendrik Harms, Lars Poulsen Tolbod, Won Yong Kim, Roni Nielsen, Jorgen Frokiaer, Kirsten Bouchelouche, Steen Hvitfeldt Poulsen, Erik Thorlund Parner, and Jens Sorensen there are no disclosures.

Supplementary material

12350_2018_1302_MOESM1_ESM.pptx (857 kb)
Supplementary material 1 (PPTX 857 kb)


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Copyright information

© American Society of Nuclear Cardiology 2018

Authors and Affiliations

  • Nils Henrik Hansson
    • 1
    Email author
  • Hendrik Johannes Harms
    • 2
  • Won Yong Kim
    • 1
  • Roni Nielsen
    • 1
  • Lars P. Tolbod
    • 2
  • Jørgen Frøkiær
    • 2
  • Kirsten Bouchelouche
    • 2
  • Steen Hvitfeldt Poulsen
    • 1
  • Henrik Wiggers
    • 1
  • Erik Thorlund Parner
    • 3
  • Jens Sörensen
    • 2
  1. 1.Department of CardiologyAarhus University HospitalAarhusDenmark
  2. 2.Department of Nuclear Medicine & PET-CenterAarhus University HospitalAarhusDenmark
  3. 3.Section for Biostatistics, Department of Public HealthAarhus UniversityAarhusDenmark

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