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Simultaneous evaluation of myocardial blood flow, cardiac function and lung water content using [15O]H2O and positron emission tomography

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

This study sought to evaluate an imaging approach using [15O]H2O and positron emission tomography (PET) for simultaneous assessment of myocardial perfusion, cardiac function and lung water content as a potential indicator of pulmonary oedema.

Methods

Twenty-six subjects divided into two groups (group I, 13 patients with idiopathic dilated cardiomyopathy; group II, 13 healthy volunteers) underwent dynamic PET scanning after intravenous infusion of ≈995 MBq [15O]H2O. In both groups, echocardiograms were performed after the PET studies. From the dynamic [15O]H2O data, lung water content (LWC) at equilibrium, myocardial blood flow (MBF), cardiac output (CO), stroke volume (SV) and stroke volume indexes (SVI) using the indicator dilution principle were determined.

Results

LWC was 18% (p = 0.038) higher in patients than in controls. Global MBF did not differ significantly between the groups, but regional MBF values were significantly lower (p < 0.05) in the anterior and septal walls in the patient group. The results of the Passing-Bablok regression indicated the absence of a systematic difference between the two techniques. Bland-Altman analysis performed for each group (patients vs healthy controls) showed a non-significant bias (p > 0.1) of −0.02 ± 0.82 vs −0.05 ± 0.54 l/min (CO), −1.44 ± 14.31 vs 1.70 ± 10.56 ml/beat (SV) and 0.47 ± 6.21 vs 0.30 ± 5.02 ml/beat/m2 (SVI). The 95% limits of agreement were −1.62 to 1.59 vs −1.11 to 1.01 l/min (CO), −26.61 to 29.49 vs −22.39 to 18.99 ml/beat (SV) and −11.69 to 12.88 vs −9.53 to 10.14 ml/beat/m2 (SVI). Right ventricular CO was increased by 33% (p = 0.014) in the patient group as compared with normal controls.

Conclusion

Our results demonstrate that additional analysis of cardiac function and lung water content are feasible from the dynamic cardiac [15O]H2O PET studies acquired for myocardial perfusion. The parameters appear to work as expected. Further studies are warranted to elucidate the clinical value of these new parameters.

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Acknowledgements

We are grateful to the technical staff from the Turku PET Centre for their assistance during the acquisition and analysis of the PET data sets.

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Authors and Affiliations

  1. Turku PET Centre, Turku University Central Hospital, P.O. Box 52, 20521, Turku, Finland

    Alexandru Naum, Helena Tuunanen, Vesa Oikonen, Hannu Sipilä, Patricia Iozzo, Pirjo Nuutila & Juhani Knuuti

  2. Department of Medicine, Turku University Central Hospital, Turku, Finland

    Erik Engblom & Pirjo Nuutila

  3. Institute of Clinical Physiology, National Research Council, Pisa, Italy

    Patricia Iozzo

Authors
  1. Alexandru Naum
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  2. Helena Tuunanen
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  3. Erik Engblom
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  4. Vesa Oikonen
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  5. Hannu Sipilä
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  6. Patricia Iozzo
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  7. Pirjo Nuutila
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  8. Juhani Knuuti
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Corresponding author

Correspondence to Juhani Knuuti.

Additional information

This study was financially supported by grants from Turku University Hospital (EVO) and Finnish Foundation for Cardiovascular Research.

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Naum, A., Tuunanen, H., Engblom, E. et al. Simultaneous evaluation of myocardial blood flow, cardiac function and lung water content using [15O]H2O and positron emission tomography. Eur J Nucl Med Mol Imaging 34, 563–572 (2007). https://doi.org/10.1007/s00259-006-0259-3

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  • DOI: https://doi.org/10.1007/s00259-006-0259-3

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