Left ventricle function assessment using gated first-pass ¹⁸F-FDG PET: Validation against equilibrium radionuclide...

Area of Science:

• Nuclear Medicine
• Cardiovascular Imaging
• Oncology

Background:

• Left ventricle (LV) function assessment is crucial for monitoring patients undergoing cardiotoxic chemotherapy.
• Equilibrium radionuclide angiography (ERNA) is a standard method, but gated first-pass 18F-FDG PET offers potential advantages.

Purpose of the Study:

• To evaluate the feasibility of assessing LV function using gated first-pass 18F-FDG PET.
• To compare the concordance of LV function measurements obtained by PET with those from ERNA.

Main Methods:

• Twenty-four oncologic patients underwent both ERNA (planar and SPECT) and gated first-pass 18F-FDG PET.
• PET images were processed in pseudo-planar and fully-tomographic modes for LV function analysis.
• Concordance and reproducibility were assessed using statistical methods like Lin's concordance correlation coefficient (ccc) and Bland-Altman analysis.

Main Results:

• Pseudo-planar PET EF estimates showed good concordance with planar ERNA (ccc = 0.81).
• Fully-tomographic PET measurements were highly concordant with SPECT ERNA for LV EDV (ccc = 0.83), ESV (ccc = 0.92), and EF (ccc = 0.89).
• Reproducibility was excellent and comparable between PET and ERNA for both methods.

Conclusions:

• Gated first-pass 18F-FDG PET is a feasible and accurate method for LV function assessment.
• It presents a relevant alternative to ERNA, allowing simultaneous evaluation of therapeutic response and cardiac toxicity.
• This technique is particularly valuable for oncologic patients receiving cardiotoxic chemotherapy.