Skip to main content
SpringerLink
Log in

Left atrial versus left ventricular input function for quantification of the myocardial blood flow with nitrogen-13 ammonia and positron emission tomography

  • Original Article
  • Published:
European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Flow quantitation with nitrogen-13 ammonia (13NH3) and positron emission tomography (PET) is dependent on an accurate blood time-activity curve. This is conveniently derived from the PET images by drawing a region of interest in the left ventricular cavity. The blood time-activity curve obtained in this way, however, may contain spillover from the myocardial wall. The purpose of this study was to analyse the effect of wall to blood pool spillover. Additionally, we analysed the application of a left atrial input function. Using computer simulations, we investigated the effect of spillover from the myocardial wall to the left ventricular input function and the effect of time delay on the left ventricular input function. An oxygen-15 carbon monoxide PET study of seven normal volunteers was used to investigate possible recovery issues regarding the left atrial input function. Finally, 13NH3 studies of 31 normal volunteers during rest and dipyridamole stimulation were analysed using either a left atrial or a left ventricular input function. The simulation studies showed that myocardial wall to blood pool spillover causes a considerable underestimation of the regional blood flow values in hyperaemic flow studies. Neither time delay nor recovery issues prevent flow quantitation with a left atrial input function. The 13NH3 studies revealed no significant difference between the resting blood flow values, whereas the hyperaemic blood flow values were underestimated by 8% (P<0.01) on average (up to 40% individually) when using a left ventricular input function compared with a left atrial input function. Spillover of activity from the left ventricular wall to the blood time-activity curve is of importance in hyperaemic flow studies using 13NH3. Application of a left atrial input function is a possible solution to these issues.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4 A
Fig. 5

Similar content being viewed by others

References

  1. Kuhle W, Porenta G, Huang SC, et al. Quantitation of regional myocardial blood flow using13N-ammonia and reoriented dynamic positron emission tomographic imaging. Circulation 1992; 86:1004–1017.

    CAS  PubMed  Google Scholar 

  2. Bol A, Melin JA, Vanoverschelde J-L, et al. Direct comparison of [13N]ammonia and [15O]water estimates of perfusion with quantification of regional myocardial blood flow by microspheres. Circulation 1993; 87:512–525.

    CAS  PubMed  Google Scholar 

  3. Nitzsche EU, Choi Y, Czernin J, Hoh CK, Huang SC, Schelbert HR. Noninvasive quantification of myocardial blood flow in humans. A direct comparison of the [13N]ammonia and the [15O]water techniques. Circulation 1996; 93:2000–2006.

    PubMed  Google Scholar 

  4. Weinberg IN, Huang SC, Hoffman EJ, et al. Validation of PET-acquired functions for cardiac studies. J Nucl Med 1988; 29:241–247.

    CAS  PubMed  Google Scholar 

  5. Rosenspire KC, Schwaiger M, Mangner TJ, Hutchins GD, Sutorik A, Kuhl DE. Metabolic fate of [13N]ammonia in human and canine blood. J Nucl Med 1990; 31:163–167.

    CAS  PubMed  Google Scholar 

  6. Krivokapich J, Smith GT, Huang SC, et al. N-13 ammonia myocardial imaging at rest and with exercise in normal volunteers: quantification of absolute myocardial perfusion with dynamic positron emission tomography. Circulation 1989; 80:1328–1337.

    CAS  PubMed  Google Scholar 

  7. Herrero P, Hartman JJ, Senneff MJ, Bergmann SR. Effects of time discrepancies between input and myocardial time-activity curves on estimates of regional myocardial perfusion with PET [see comments]. J Nucl Med 1994; 35:558–566.

    CAS  PubMed  Google Scholar 

  8. Smith GT, Huang SC, Nienaber CA, Krivokapich J, Schelbert HR. Noninvasive quantification of regional myocardial blood flow with N-13 ammonia and dynamic PET. J Nucl Med 1988; 29:940.

    Google Scholar 

  9. Gambhir SS, Mahoney DK, Huang SC, Phelps ME. Symbolic Interactive Modeling Package and Learning Environment (SIMPLE), a new easy method for compartmental modeling. Proceedings of the Society for Computer Simulation 1996:173–186.

  10. Iida H, Miura S, Kanno I, et al. Design and evaluation of HEADTOME-IV, a whole body positron emission tomograph. IEEE Trans Nucl Sci 1989; NS36:1006–1010.

    Article  Google Scholar 

  11. Martin W, Powers W, Raichle M. Cerebral blood volume measured with inhaled C15O and positron emission tomography. J Cereb Blood Flow Metab 1987; 7:421–426.

    CAS  PubMed  Google Scholar 

  12. DeGrado TR, Turkington TG, Williams JJ, Stearns CW, Hoffman JM, Coleman RE. Performance characteristics of a whole-body PET scanner. J Nucl Med 1994; 35:1398–1406.

    CAS  PubMed  Google Scholar 

  13. Kofoed KF, Hove JD, Freiberg J, Høst U, Hesse B, Kelbaek H. Relationship between regional18F-fluordeoxyglucose and 13N-ammonia uptake in normal myocardium assessed by positron emission tomography. Patterns of mismatch and effects of aging. Int J Card Imaging 2001; 17:361–370.

    CAS  Google Scholar 

  14. Nyboe J, Jensen G, Appleyard M, Schnohr P. Risk factors for acute myocardial infarction in Copenhagen. I. Hereditary, educational and socioeconomic factors. Copenhagen City Heart Study. Eur Heart J 1989; 10:910–916.

    CAS  PubMed  Google Scholar 

  15. Yoshida K, Gould L, Mullani N, Pina V, Seiler C. Dipyridamole alters arterial input function for PET perfusion imaging [abstract]. J Nucl Med 1991; 5:1040.

    Google Scholar 

  16. Yoshida K, Endo M, Fukuda H, et al. Measurement of arterial tracer concentration from cardiac PET images. J Comput Assist Tomogr 1995; 19:182–187.

    CAS  PubMed  Google Scholar 

  17. Kofoed KF, Schoder H, Knight RJ, Buxton DB. Glucose metabolism in reperfused myocardium measured by [2-18F]2-fluorodeoxyglucose and PET. Cardiovasc Res 2000; 45:321–329.

    CAS  PubMed  Google Scholar 

  18. Wu HM, Hoh CK, Choi Y, et al. Factor analysis for extraction of blood time-activity curves in dynamic FDG-PET studies. J Nucl Med 1995; 36:1714–1722.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We are grateful for the collaboration with Merete Appleyard, The Copenhagen City Heart Study. The assistance of Drs. Birger Hesse, Liselotte Højgaard, Markus Nowak and Mikael Jensen, The Cyclotron and PET unit, Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet is highly appreciated. Helle Jung Larsen, Käte Petersen, Brita Dondera and Bitten Vindberg are thanked for excellent technical assistance.

Author information

Authors and Affiliations

  1. Department of Cardiology, Medical Department B, The Heart Center, Rigshospitalet, DK 2100, Copenhagen, Denmark

    Jens D. Hove, Klaus F. Kofoed, Jacob Freiberg & Henning Kelbaek

  2. The Neurobiological Research Unit, Rigshospitalet, Copenhagen, Denmark

    Hidehiro Iida

  3. The PET Center and the Department of Nuclear Medicine and Clinical Physiology, Rigshospitalet, Copenhagen, Denmark

    Søren Holm

Authors
  1. Jens D. Hove
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hidehiro Iida
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Klaus F. Kofoed
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jacob Freiberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Søren Holm
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Henning Kelbaek
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jens D. Hove.

Additional information

An abstract of this paper was presented at the Society of Nuclear Medicine meeting in San Antonio, 1997.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hove, J.D., Iida, H., Kofoed, K.F. et al. Left atrial versus left ventricular input function for quantification of the myocardial blood flow with nitrogen-13 ammonia and positron emission tomography. Eur J Nucl Med Mol Imaging 31, 71–76 (2004). https://doi.org/10.1007/s00259-003-1329-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-003-1329-4

Keywords

Search

Navigation