Feasibility of biventricular volume and function assessment using first-pass gated

Area of Science:

• Cardiovascular Imaging
• Nuclear Cardiology
• Radiochemistry

Background:

• Assessing left ventricular (LV) and right ventricular (RV) function is crucial in cardiology.
• Traditional methods like echocardiography and SPECT have limitations.
• Positron Emission Tomography (PET) offers potential for advanced cardiac imaging.

Purpose of the Study:

• To evaluate the feasibility of using first-pass gated 15O-water PET for LV and RV volume and function estimation.
• To compare PET-derived parameters with those obtained from gated myocardial SPECT.
• To assess the reliability of PET in both resting and stress conditions.

Main Methods:

• 19 patients underwent rest and regadenoson stress 15O-water PET for myocardial perfusion reserve assessment.
• Gated first-pass PET images were reconstructed and processed using TomPool software.
• LV and RV segmentation utilized a semi-automated 4D immersion algorithm.
• LV volumes were calculated using a count-based model; RV volumes used a geometrical model.
• Ejection curves were fitted with a deformable reference curve model.

Main Results:

• Excellent concordance was observed between rest and stress PET for LV and RV end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and ejection fraction (EF).
• High correlation was found between PET and SPECT for LV EDV (R=0.89) and ESV (R=0.87).
• Satisfactory correlation was noted for LV SV (R=0.67) and EF (R=0.67).
• PET showed minimal LV ESV overestimation (+4 mL) and EF underestimation (-4%).

Conclusions:

• First-pass gated 15O-water PET is a feasible method for biventricular volume and function assessment.
• PET-derived LV parameters demonstrate good correlation with gated myocardial SPECT.
• This technique shows promise for comprehensive cardiac function evaluation.