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Evaluation of right ventricular volume and ejection fraction by gated 18F-FDG PET in patients with pulmonary hypertension: Comparison with cardiac MRI and CT

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Right ventricular (RV) function is a powerful predictor of survival in patients with pulmonary hypertension (PH), but noninvasively assessing RV function remains a challenge. The aim of this study was to prospectively compare gated 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) myocardial imaging (gated PET), cardiac magnetic resonance (CMR), and cardiac computed tomography (CCT) for the assessment of RV volume and ejection fraction in patients with PH.

Methods

Twenty-three consecutive patients aged more than 16 years diagnosed with PH were included. All patients underwent gated PET, CMR, and CCT within 7 days. Right ventricular end-diastolic volume (RVEDV), right ventricular end-systolic volume (RVESV), and right ventricular ejection fraction (RVEF) were calculated by three imaging modalities. RV 18F-FDG uptake was determined as RV-corrected standardized uptake value (SUV), and the ratio of RV to left ventricular (LV)-corrected SUV (Corrected SUV R/L).

Results

Gated PET showed a moderate correlation (r = 0.680, P < .001) for RVEDV, good correlation for RVESV (r = 0.757, P < .001) and RVEF (r = 0.788, P < .001) with CMR, and good correlation for RVEDV (r = 0.767, P < .001), RVESV (r = 0.837, P < .001), and RVEF (r = 0.730, P < .001) with CCT. Bland-Altman analysis revealed systematic underestimation of RVEDV and RVESV and overestimation of RVEF with gated PET compared with CMR and CCT. The correlation between RVESV (r = 0.863, P < .001), RVESV (r = 0.903, P < .001), and RVEF (r = 0.853, P < .001) of CMR and those of CCT was excellent; Bland-Altman analysis showed only a slight systematic variation between CMR and CCT. There were statistically significant negative correlations between RV-corrected SUV and RVEF-CMR (r = −0.543, P < .01), Corrected SUV R/L and RVEF-CMR (r = −0.521, P < .05), RV-corrected SUV and RVEF-CCT (r = −0.429, P < .05), Corrected SUV R/L and RVEF-CCT (r = −0.580, P < .01), respectively.

Conclusion

Gated PET had moderate-to-high correlation with CMR and CCT in the assessments of RV volume and ejection fraction. It is an available method for simultaneous assessing of RV function and myocardial glucose metabolism in patients with PH.

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Acknowledgments

This study is supported by Beijing Municipal Science and Technology Project (Z090507017709032) and the Capital Medical Development and Research Fund (2009-1003).

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Authors and Affiliations

  1. Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 167 Beilishi Road, Beijing, 100037, China

    Lei Wang MD & Wei Fang MD

  2. Department of Radiology, Cardiovascular Institute and Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100037, China

    Yan Zhang MD, Chaowu Yan MD & Shihua Zhao MD

  3. Center for Diagnosis and Management of Pulmonary Vascular Diseases, Department of Cardiology, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China

    Jianguo He MD & Changming Xiong MD

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  1. Lei Wang MD
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Correspondence to Wei Fang MD.

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Wang, L., Zhang, Y., Yan, C. et al. Evaluation of right ventricular volume and ejection fraction by gated 18F-FDG PET in patients with pulmonary hypertension: Comparison with cardiac MRI and CT. J. Nucl. Cardiol. 20, 242–252 (2013). https://doi.org/10.1007/s12350-013-9672-8

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  • DOI: https://doi.org/10.1007/s12350-013-9672-8

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