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How to detect and correct myocardial creep in myocardial perfusion imaging using Rubidium-82 PET?

S S Koenders1,2, J D van Dijk3, P L Jager3

  • 1Department of Nuclear Medicine, Isala hospital, PO Box 10400, 8000 GK, Zwolle, The Netherlands. skoenders93@gmail.com.

Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology
|February 22, 2019
PubMed

Insights

This study addresses myocardial creep, a common issue in cardiac PET imaging that affects blood flow measurements. We offer methods to detect and correct this artifact for more reliable myocardial perfusion imaging results.

Area of Science:

  • Nuclear medicine
  • Cardiovascular imaging
  • Medical physics

Background:

  • Myocardial perfusion imaging (MPI) using Positron Emission Tomography (PET) is crucial for assessing heart health.
  • Quantification of myocardial blood flow (MBF) is vital for accurate diagnosis.
  • Myocardial creep, a motion artifact, can significantly compromise MBF accuracy during pharmacologically induced stress.

Purpose of the Study:

  • To provide clear instructions for detecting and correcting myocardial creep in PET MPI.
  • To evaluate the capabilities of current software packages in addressing this quality control issue.
  • To offer guidance on essential clinical considerations for precise MBF quantification.

Main Methods:

  • Detailed comparison of myocardium contours and observed activity across PET image time frames to identify misalignments.
  • Review and analysis of functionalities within common MPI software packages for myocardial creep detection.
  • Compilation of clinical best practices for optimizing MBF measurements.

Main Results:

  • Established methods for identifying myocardial creep by analyzing temporal changes in myocardial contours and activity distribution.
  • Identified variability in software support for myocardial creep correction, highlighting a need for improved functionality.
  • Outlined key clinical factors influencing MBF accuracy, emphasizing the importance of standardized protocols.

Conclusions:

  • Myocardial creep is a significant confounder in PET MPI that requires specific detection and correction strategies.
  • Standardized quality control measures, including software enhancements, are necessary for reliable MBF quantification.
  • Adherence to clinical guidelines is paramount for achieving accurate and reproducible myocardial blood flow assessments.
Keywords:
82RbMyocardial blood flowPET myocardial perfusion imagingmyocardial creeppharmacological vasodilators

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