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13N-ammonia positron emission tomography-derived left-ventricular strain in patients after heart transplantation validated using cardiovascular magnetic resonance feature tracking as reference

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Abstract

Objective

Heart transplant rejection leads to cardiac allograft vasculopathy (CAV). 13N-ammonia positron emission tomography (PET) can be useful in detecting CAV, as it can evaluate both epicardial vessels and microvasculature. In this study, we evaluated the regional wall motion in heart transplant patients using our PET-specific feature-tracking (FT) algorithm for myocardial strain calculation and validated it using a cardiovascular magnetic resonance (CMR) FT strain as a reference.

Methods

A total of 15 heart transplant patients who underwent both 13N-ammonia PET and CMR within 3 months were retrospectively enrolled. The same slice position of short-axis cine images of the middle slice of left ventricle (LV) and the same slice position of horizontal long-axis cine images were selected for the two modalities to measure the circumferential strain (CS) and longitudinal strain (LS), respectively. Based on the FT technique, time–strain curves were calculated by semi-automatic tracking of the endocardial contour on cine images throughout a cardiac cycle. The peak value in the time-strain curve was defined as the representative value. Correlations of CS and LS between PET and CMR were analyzed using Pearson correlation coefficients. The inter-modality error of strain measurements was evaluated using intraclass correlation coefficients (ICCs) with two-way random single measures.

Results

Excellent correlations of CS and LS between PET and CMR were observed (CS: r = 0.80; p < 0.01; LS: r = 0.87; p < 0.01). Excellent ICCs were observed (0.89 and 0.85) in CS and LS derived from PET.

Conclusions

We propose the first PET strain showing an excellent agreement with the CMR strain and high reproducibility in measurement.

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Acknowledgements

The authors thank Editage (www.editage.com) for English language editing.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan

    Masateru Kawakubo & Masayuki Sasaki

  2. Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Michinobu Nagao, Atsushi Yamamoto, Yuka Matsuo, Koichiro Kaneko & Shuji Sakai

  3. Department of Cardiology, Tokyo Women’s Medical University, Tokyo, Japan

    Noriko Kikuchi, Risako Nakao & Eri Watanabe

  4. Department of Therapeutic Strategy for Severe Heart Failure, Graduate School of Medicine, Tokyo Women’s Medical University, Tokyo, Japan

    Shinichi Nunoda

Authors
  1. Masateru Kawakubo
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  4. Atsushi Yamamoto
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Contributions

MK and MN contributed to the initial design of the project. All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by MN, NK, and AY. All authors contributed to the interpretation of the data. The first draft of the manuscript was written by MK, and all authors commented and revised previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Michinobu Nagao.

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Kawakubo, M., Nagao, M., Kikuchi, N. et al. 13N-ammonia positron emission tomography-derived left-ventricular strain in patients after heart transplantation validated using cardiovascular magnetic resonance feature tracking as reference. Ann Nucl Med 36, 70–81 (2022). https://doi.org/10.1007/s12149-021-01686-5

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