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Automated dynamic motion correction using normalized gradient fields for 82rubidium PET myocardial blood flow quantification

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Patient motion can lead to misalignment of left ventricular (LV) volumes-of-interest (VOIs) and subsequently inaccurate quantification of myocardial blood flow (MBF) and flow reserve (MFR) from dynamic PET myocardial perfusion images. We aimed to develop an image-based 3D-automated motion-correction algorithm that corrects the full dynamic sequence for translational motion, especially in the early blood phase frames (~ first minute) where the injected tracer activity is transitioning from the blood pool to the myocardium and where conventional image registration algorithms have had limited success.

Methods

We studied 225 consecutive patients who underwent dynamic rest/stress rubidium-82 chloride (82Rb) PET imaging. Dynamic image series consisting of 30 frames were reconstructed with frame durations ranging from 5 to 80 seconds. An automated algorithm localized the RV and LV blood pools in space and time and then registered each frame to a tissue reference image volume using normalized gradient fields with a modification of a signed distance function. The computed shifts and their global and regional flow estimates were compared to those of reference shifts that were assessed by three physician readers.

Results

The automated motion-correction shifts were within 5 mm of the manual motion-correction shifts across the entire sequence. The automated and manual motion-correction global MBF values had excellent linear agreement (R = 0.99, y = 0.97x + 0.06). Uncorrected flows outside of the limits of agreement with the manual motion-corrected flows were brought into agreement in 90% of the cases for global MBF and in 87% of the cases for global MFR. The limits of agreement for stress MBF were also reduced twofold globally and by fourfold in the RCA territory.

Conclusions

An image-based, automated motion-correction algorithm for dynamic PET across the entire dynamic sequence using normalized gradient fields matched the results of manual motion correction in reducing bias and variance in MBF and MFR, particularly in the RCA territory.

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Abbreviations

MBF:

Myocardial blood flow

MFR:

Myocardial flow reserve

PET:

Positron emission tomography

LVBP:

Left ventricular blood pool

RVBP:

Right ventricular blood pool

VOI:

Volume-of-interest

TAC:

Time-activity curve

HLA:

Horizontal long-axis

NGF:

Normalized gradient field

LAD:

Left anterior descending artery

LCX:

Left circumflex

RCA:

Right coronary artery

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Disclosures

B.C. Lee, J.B. Moody, and A. Poitrasson-Rivière are employees of INVIA Medical Imaging Solutions. A.C. Melvin and R.L. Weinberg have no disclosures. J.R. Corbett and E.P. Ficaro are owners of INVIA Medical Imaging Solutions. V.L. Murthy has received consulting fees from Ionetix, Inc, and owns stock in General Electric and Cardinal Health, and stock options in Ionetix, Inc. V. L. Murthy is supported by 1R01HL136685 from the National, Heart, Lung, Blood Institute, and research Grants from INVIA Medical Imaging Solutions and Siemens Medical Imaging.

Author information

Author notes

  1. Edward P. Ficaro and Venkatesh L. Murthy contributed equally to this work and are co-senior authors

Authors and Affiliations

  1. INVIA Medical Imaging Solutions, 3025 Boardwalk St., Suite 200, Ann Arbor, MI, 48108, USA

    Benjamin C. Lee PhD, Jonathan B. Moody PhD, Alexis Poitrasson-Rivière PhD, James R. Corbett MD & Edward P. Ficaro PhD

  2. Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, MI, USA

    Amanda C. Melvin MS, James R. Corbett MD, Venkatesh L. Murthy MD, PhD & Edward P. Ficaro PhD

  3. Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA

    Richard L. Weinberg MD, PhD

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  1. Benjamin C. Lee PhD
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Correspondence to Edward P. Ficaro PhD.

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Lee, B.C., Moody, J.B., Poitrasson-Rivière, A. et al. Automated dynamic motion correction using normalized gradient fields for 82rubidium PET myocardial blood flow quantification. J. Nucl. Cardiol. 27, 1982–1998 (2020). https://doi.org/10.1007/s12350-018-01471-4

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  • DOI: https://doi.org/10.1007/s12350-018-01471-4

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