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Automatic volumetric estimates of the left and right atrium using dynamic PET
Hendrik J Harms1,2,3, Bent Roni Nielsen2, Tanja Kero1
1Department of Surgical Sciences, Molecular Imaging and Physics, Uppsala University, Dag Hammarskjölds Väg 14B, plan 0, Uppsala, 75183, Sweden.
EJNMMI Research
|December 5, 2025
Summary
This study presents an automated method for measuring left and right atrial volumes using dynamic cardiac PET scans. This technique accurately and reproducibly assesses cardiovascular risk markers without ECG-gating.
Area of Science:
- Cardiovascular imaging
- Nuclear medicine
- Cardiac PET analysis
Background:
- Left (LAV) and right (RAV) atrial volumes are key cardiovascular risk indicators in heart failure.
- Simultaneous assessment of myocardial blood flow (MBF) and atrial volumes could enhance cardiac PET's clinical value.
Purpose of the Study:
- To develop and validate an automated method for determining atrial volumes from dynamic myocardial perfusion PET scans.
- To enable atrial volume assessment without the need for ECG-gating.
Main Methods:
- Developed an automated segmentation technique using first-pass [15O]-water PET data.
- Combined voxel-wise images of bolus area-under-curve and arrival time for segmentation.
- Validated the method across multiple patient cohorts (systolic heart failure, hypertrophic cardiomyopathy, cardiac amyloidosis, controls) and assessed test-retest repeatability.
Main Results:
- Automated segmentation was successful in all 125 scans.
- PET-derived atrial volumes strongly correlated with echocardiography (LAV: r=0.83, RAV: r=0.77, p<0.001).
- Excellent test-retest reproducibility was observed for both LAV (ICC=0.96) and RAV (ICC=0.96).
Conclusions:
- Dynamic PET allows for automated, accurate, and reproducible extraction of left and right atrial volumes.
- This automated method holds promise for improved cardiovascular risk assessment in clinical practice.
