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Quantification of myocardial blood flow using dynamic myocardial CT perfusion compared with 82Rb PET

Mathias B Møller1, Philip Hasbak2, Jesper J Linde1

  • 1Department of Cardiology, The Heart Centre, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.

Journal of Cardiovascular Computed Tomography
|April 6, 2023
PubMed
Abstract

Insights

Dynamic CT perfusion underestimates myocardial blood flow. This study developed an extraction function for iodinated contrast agents, improving CT-derived MBF accuracy and correlation with PET in healthy individuals.

Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Medical Physics

Background:

  • Dynamic myocardial CT perfusion (DM-CTP) underestimates absolute myocardial blood flow (MBF) compared to reference standards.
  • Incomplete extraction of iodinated contrast agent (iCA) in myocardial tissue contributes to underestimation.

Purpose of the Study:

  • To establish an extraction function for iCA in DM-CTP.
  • To calculate MBF using the derived extraction function (MBFCT).
  • To compare MBFCT with MBF measured by 82Rb positron emission tomography (PET).

Main Methods:

  • Healthy individuals without coronary artery disease (CAD) underwent 82Rb PET and DM-CTP.
  • Factors (α and β) of the generalized Renkin-Crone model were estimated using non-linear least squares.
  • The best-fit factors were used to calculate MBFCT.

Main Results:

  • The best-fit factors were α = 0.614 and β = 0.218 (R-squared = 0.81).
  • Conversion of CT inflow parameter (K1) using the extraction function showed significant correlation between CT and PET MBF during stress (P = 0.039).

Conclusions:

  • In healthy individuals, MBF estimates from DM-CTP correlate with absolute MBF quantified by 82Rb PET after correction for iCA extraction.
  • The developed extraction function improves the accuracy of MBF assessment using DM-CTP.
Keywords:
(82)Rb positron emission tomographyDynamic myocardial CT perfusionExtraction of iodinated contrast agentMyocardial blood flowQuantification

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