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Blood pool and tissue phase patient motion effects on 82rubidium PET myocardial blood flow quantification

Benjamin C Lee1, Jonathan B Moody2, Alexis Poitrasson-Rivière2

  • 1INVIA Medical Imaging Solutions, 3025 Boardwalk St., Suite 200, Ann Arbor, MI, 8108, USA. blee@inviasolutions.com.

Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology
|March 25, 2018
PubMed
Abstract

Insights

Patient motion during dynamic PET imaging significantly impacts myocardial blood flow (MBF) and flow reserve (MFR) quantification. Motion in the blood phase, particularly inferiorly, causes substantial errors, necessitating targeted motion correction strategies.

Area of Science:

  • Nuclear Medicine
  • Cardiovascular Imaging
  • Medical Physics

Background:

  • Dynamic PET myocardial perfusion imaging is susceptible to patient motion.
  • Motion can misalign left ventricular volumes, leading to inaccurate myocardial blood flow (MBF) and flow reserve (MFR) quantification.
  • Understanding motion prevalence and impact is crucial for accurate diagnostic interpretation.

Purpose of the Study:

  • To determine the prevalence of patient motion during dynamic PET myocardial perfusion imaging.
  • To analyze the effects of motion during blood and tissue phases on MBF and MFR estimates.
  • To identify specific motion characteristics that most significantly affect flow quantification.

Main Methods:

  • 225 patients undergoing dynamic rubidium-82 chloride PET imaging were analyzed.
  • Motion was assessed by 3 physicians from dynamic series, noting frequency, magnitude, time, and direction.
  • Effects of isolated motion on global and regional MBF/MFR were evaluated using motion-corrected images as references.

Main Results:

  • Mild to moderate motion (5-15 mm) occurred in 63% (stress) and 44% (rest) of studies, primarily during the blood phase.
  • Blood phase motion caused mean global MBF/MFR errors of 2-5%.
  • Inferiorly directed blood phase motion led to significant errors (29-44%) in the RCA territory; tissue phase motion errors were <1%.

Conclusions:

  • Patient motion is most common in the blood phase of dynamic PET myocardial perfusion imaging.
  • Inferiorly directed motion during the blood phase substantially increases MBF and MFR errors.
  • Targeted motion correction strategies focusing on blood phase and inferior motion are essential for improving accuracy.
Keywords:
Coronary blood flowCoronary flow reserveImage artifactsMyocardial perfusion imaging: PETPharmacologic stress

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