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Electrocardiographically gated 11C-hydroxyephedrine PET for the simultaneous assessment of cardiac sympathetic and contractile functions

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Abstract

Objective

Application of the electrocardiographically (ECG) gated positron emission tomography (PET) technique with 11C-hydroxyephedrine (HED) would allow the simultaneous assessment of cardiac sympathetic and contractile functions. However, there are uncertainties regarding the diagnostic accuracy of left ventricular (LV) volume measurements using ECG-gated HED-PET. The purpose of this study was to clarify the minimal requirement of count statistics to measure LV volumes with ECG-gated HED-PET and to investigate the reliability of the measurements.

Methods

Five healthy volunteers and 11 patients with heart failure underwent a 40-min list-mode PET scan after an injection of HED (197 ± 35 MBq). The list-mode data were histogrammed into multiple sets of acquisition periods at 0.5, 1.0, 2.0, 4.0, 6.0, 8.0, 12.0 Mcount/bin and reconstructed into corresponding gated images using an iterative algorithm. The LV end-diastolic volume (LVEDV), the LV end-systolic volume (LVESV), and the LV ejection fraction (LVEF) were calculated in each acquisition period. These values were compared with those obtained by cardiac magnetic resonance imaging (MRI). Possible effects of HED retention on the accuracy of the volume measurements were investigated.

Results

Collecting less than 4.0 Mcount/bin resulted in noisy cardiac images. The lower counts resulted in underestimation in the volume measurements. Reasonably accurate volume measurements required equal to or greater than 6.0 Mcount/bin. This corresponded to 7.0 ± 1.9 min (range, 4.0–10.3 min) for the acquisition period. Volumetric results using the 6.0 Mcount/bin data highly correlated with cardiac MRI (LVEDV: r = 0.85, p < 0.0001; LVESV: r = 0.89, p < 0.0001; LVEF: r = 0.77, p < 0.01). The HED retention did not affect the volumetric results compared to the MRI volumetry.

Conclusions

The volumetric accuracy with ECG-gated HED-PET was affected by the count statistics rather than the HED retention. LV volume measurements were feasible with 10-min acquisition period for most of the patients. This technique allows the simultaneous assessment of cardiac sympathetic and contractile functions without the need for an additional injection or scanning time, thus reducing overall costs for diagnostic imaging.

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Conflict of interest

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Authors and Affiliations

  1. Department of Radiology, Hokkaido University Hospital, Kita 14 Nishi 5, Kita-ku, Sapporo, Hokkaido, 060-8648, Japan

    Keiichi Magota

  2. Department of Molecular Imaging, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan

    Naoya Hattori & Keiichiro Yoshinaga

  3. Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan

    Osamu Manabe, Tohru Shiga & Nagara Tamaki

  4. Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan

    Masanao Naya, Shiro Yamada & Mamoru Sakakibara

  5. Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Kita 14 Nishi 5, Kita-ku, Sapporo, Hokkaido, 060-8648, Japan

    Noriko Oyama-Manabe

  6. Central Institute of Isotope Science, Hokkaido University, Kita 15 Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0815, Japan

    Yuji Kuge

Authors
  1. Keiichi Magota
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  2. Naoya Hattori
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  3. Osamu Manabe
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  4. Masanao Naya
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  6. Tohru Shiga
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  7. Yuji Kuge
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  8. Shiro Yamada
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  9. Mamoru Sakakibara
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  10. Keiichiro Yoshinaga
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  11. Nagara Tamaki
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Correspondence to Naoya Hattori.

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Magota, K., Hattori, N., Manabe, O. et al. Electrocardiographically gated 11C-hydroxyephedrine PET for the simultaneous assessment of cardiac sympathetic and contractile functions. Ann Nucl Med 28, 187–195 (2014). https://doi.org/10.1007/s12149-013-0795-4

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  • DOI: https://doi.org/10.1007/s12149-013-0795-4

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