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Effect of temporal sampling protocols on myocardial blood flow measurements 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.
Background:
A variety of temporal sampling protocols is used worldwide to measure myocardial blood flow (MBF). Both the length and number of time frames in these protocols may alter MBF and myocardial flow reserve (MFR) measurements. We aimed to assess the effect of different clinically used temporal sampling protocols on MBF and MFR quantification in Rubidium-82 (Rb-82) PET imaging.
Methods:
We retrospectively included 20 patients referred for myocardial perfusion imaging using Rb-82 PET. A literature search was performed to identify appropriate sampling protocols. PET data were reconstructed using 14 selected temporal sampling protocols with time frames of 5-10 seconds in the first-pass phase and 30-120 seconds in the tissue phase. Rest and stress MBF and MFR were calculated for all protocols and compared to the reference protocol with 26 time frames.
Results:
MBF measurements differed (P ≤ 0.003) in six (43%) protocols in comparison to the reference protocol, with mean absolute relative differences up to 16% (range 5%-31%). Statistically significant differences were most frequently found for protocols with tissue phase time frames < 90 seconds. MFR did not differ (P ≥ 0.11) for any of the protocols.
Conclusions:
Various temporal sampling protocols result in different MBF values using Rb-82 PET. MFR measurements were more robust to different temporal sampling protocols.
Insights
Different temporal sampling protocols significantly impact myocardial blood flow (MBF) measurements using Rubidium-82 (Rb-82) PET imaging. However, myocardial flow reserve (MFR) quantification remains robust across various protocols.
Area of Science:
- Nuclear Cardiology
- Cardiovascular Imaging
- Radiopharmaceutical Dosimetry
Background:
- Myocardial blood flow (MBF) and myocardial flow reserve (MFR) are crucial metrics in cardiovascular assessment.
- Standardization of temporal sampling protocols in Rubidium-82 (Rb-82) Positron Emission Tomography (PET) imaging is lacking.
- Variations in sampling protocols may influence the accuracy of MBF and MFR quantification.
Purpose of the Study:
- To evaluate the impact of diverse, clinically utilized temporal sampling protocols on MBF and MFR measurements.
- To compare MBF and MFR quantification across 14 distinct temporal sampling protocols against a reference protocol.
- To identify which temporal sampling parameters most significantly affect Rb-82 PET derived myocardial perfusion metrics.
Main Methods:
- Retrospective analysis of Rb-82 PET data from 20 patients undergoing myocardial perfusion imaging.
- Reconstruction of PET data using 14 selected temporal sampling protocols with varying time frame durations.
- Calculation and comparison of rest and stress MBF and MFR values for each protocol against a 26-frame reference protocol.
Main Results:
- Significant differences in MBF measurements were observed in 43% of the tested protocols compared to the reference (P ≤ 0.003).
- Mean absolute relative differences in MBF ranged from 5% to 31%, with larger deviations noted for protocols using shorter tissue phase frames (<90 seconds).
- Myocardial flow reserve (MFR) values showed no statistically significant differences across any of the evaluated temporal sampling protocols (P ≥ 0.11).
Conclusions:
- Temporal sampling protocols significantly influence myocardial blood flow (MBF) quantification using Rb-82 PET.
- Myocardial flow reserve (MFR) measurements demonstrate greater robustness and are less affected by variations in temporal sampling protocols.
- Optimizing temporal sampling in Rb-82 PET is essential for accurate MBF assessment, while MFR appears more reliable across different acquisition schemes.
