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Updated: Oct 8, 2025
MRI and PET in Mouse Models of Myocardial Infarction
Published on: December 19, 2013
Improved myocardial blood flow estimation with residual activity correction and motion correction in 18F-flurpiridaz
Yuka Otaki1, Serge D Van Kriekinge1, Chih-Chun Wei1
1Department of Medicine (Division of Artificial Intelligence)- Imaging- and Biomedical Sciences- Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Ste. Metro 203, Los Angeles, CA, 90048, USA.
Purpose:
We sought to evaluate the diagnostic performance for coronary artery disease (CAD) of myocardial blood flow (MBF) quantification with 18F-flurpiridaz PET using motion correction (MC) and residual activity correction (RAC).
Methods:
In total, 231 patients undergoing same-day pharmacologic rest and stress 18F-flurpiridaz PET from Phase III Flurpiridaz trial (NCT01347710) were studied. Frame-by-frame MC was performed and RAC was accomplished by subtracting the rest residual counts from the dynamic stress polar maps. MBF and myocardial flow reserve (MFR) were derived with a two-compartment early kinetic model for the entire left ventricle (global), each coronary territory, and 17-segment. Global and minimal values of three territorial (minimal vessel) and segmental estimation (minimal segment) of stress MBF and MFR were evaluated in the prediction of CAD. MBF and MFR were evaluated with and without MC and RAC (1: no MC/no RAC, 2: no MC/RAC, 3: MC/RAC).
Results:
The area-under the receiver operating characteristics curve (AUC [95% confidence interval]) of stress MBF with MC/RAC was higher for minimal segment (0.89 [0.85-0.94]) than for minimal vessel (0.86 [0.81-0.92], p = 0.03) or global estimation (0.81 [0.75-0.87], p < 0.0001). The AUC of MFR with MC/RAC was higher for minimal segment (0.87 [0.81-0.93]) than for minimal vessel (0.83 [0.76-0.90], p = 0.014) or global estimation (0.77 [0.69-0.84], p < 0.0001). The AUCs of minimal segment stress MBF and MFR with MC/RAC were higher compared to those with no MC/RAC (p < 0.001 for both) or no MC/no RAC (p < 0.0001 for both).
Conclusions:
Minimal segment MBF or MFR estimation with MC and RAC improves the diagnostic performance for obstructive CAD compared to global assessment.
Insights
Quantification of myocardial blood flow (MBF) and myocardial flow reserve (MFR) using 18F-flurpiridaz PET with motion correction (MC) and residual activity correction (RAC) significantly improves diagnostic performance for coronary artery disease (CAD). Minimal segment analysis offers superior accuracy over global assessment.
Area of Science:
- Nuclear cardiology
- Cardiovascular imaging
- Radiopharmaceutical diagnostics
Background:
- Coronary artery disease (CAD) diagnosis relies on accurate assessment of myocardial perfusion.
- 18F-flurpiridaz positron emission tomography (PET) offers potential for quantitative myocardial blood flow (MBF) and myocardial flow reserve (MFR) assessment.
- Image correction techniques are crucial for optimizing diagnostic accuracy in PET imaging.
Purpose of the Study:
- To evaluate the diagnostic performance of 18F-flurpiridaz PET-derived MBF and MFR for detecting coronary artery disease (CAD).
- To assess the impact of motion correction (MC) and residual activity correction (RAC) on diagnostic accuracy.
- To compare the performance of global, territorial (vessel), and segmental MBF/MFR estimations.
Main Methods:
- Utilized data from 231 patients in the Phase III Flurpiridaz trial undergoing rest/stress 18F-flurpiridaz PET.
- Applied frame-by-frame MC and RAC by subtracting rest counts from stress polar maps.
- Calculated MBF and MFR using a two-compartment kinetic model for global, territorial, and segmental analyses, with and without MC/RAC.
Main Results:
- The area under the receiver operating characteristic curve (AUC) for stress MBF with MC/RAC was highest for minimal segment estimation (0.89) compared to minimal vessel (0.86) and global (0.81) assessments.
- Similarly, the AUC for MFR with MC/RAC was highest for minimal segment (0.87) versus minimal vessel (0.83) and global (0.77) estimations.
- MC/RAC significantly improved AUCs for minimal segment MBF and MFR compared to analyses without these corrections.
Conclusions:
- Minimal segment MBF and MFR quantification with MC and RAC enhances diagnostic performance for obstructive CAD.
- Segmental analysis provides superior diagnostic accuracy compared to global assessment in 18F-flurpiridaz PET imaging.
- MC and RAC are essential for optimizing the diagnostic utility of 18F-flurpiridaz PET in CAD detection.
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