Effect of PET-CT misalignment on the quantitative accuracy of cardiac 15 O-water PET
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Department of Surgical Sciences/Nuclear Medicine & PET, Uppsala University, Uppsala, Sweden Medical Physics, Uppsala University Hospital, Uppsala, Sweden Nuclear Medicine & Clinical Physiology, Aarhus University Hospital, Aarhus, Denmark Medical Imaging Centre, Uppsala University Hospital, Uppsala, Sweden ¨vleborg County, Ga ¨vle, Sweden Centre for Research and Development, Uppsala/Ga MedTrace Pharma A/S, Lyngby, Denmark PET Centre, Uppsala University Hospital, Uppsala, Sweden
Received Jul 23, 2020; accepted Sep 29, 2020 doi:10.1007/s12350-020-02408-6
Background. Quantification of myocardial blood flow (MBF) with PET requires accurate attenuation correction, which is performed using a separate CT. Misalignment between PET and CT scans has been reported to be a common problem. The purpose of the present study was to assess the effect of PET CT misalignment on the quantitative accuracy of cardiac 15O-water PET. Methods. Ten clinical patients referred for evaluation of ischemia and assessment of MBF with 15O-water were included in the study. Eleven different misalignments between PET and CT were induced in 6 different directions with 10 and 20 mm amplitudes: caudal (1Z), cranial (2 Z), lateral (±X), anterior (1Y), and anterior combined with cranial (1 Y and 2 Z). Blood flow was quantified from rates of washout (MBF) and uptake (transmural MBF, MBFt) for the whole left ventricle and the three coronary territories. The results from all misalignments were compared to the original scan without misalignment. Results. MBF was only minorly affected by misalignments, but larger effects were seen in MBFt. On the global level, average absolute deviation across all misalignments for MBF was 1.7% ± 1.4% and for MBFt 5.4% ± 3.2 Largest deviation for MBF was 2 4.8% ± 5.8% (LCX, X 1 20) and for MBFt 2 19.3% ± 9.6% (LCX, X 1 20). In general, larger effects were seen in LAD and LCX compared to in RCA. Conclusion. The quantitative accuracy of MBF from 15O-water PET, based on the washout of the tracer, is only to a minor extent affected by misalignment between PET and CT. (J Nucl Cardiol 2020) Key Words: PET Æ myocardial blood flow Æ image analysis Æ perfusion agents The authors of this article have provided a PowerPoint file, available for download at SpringerLink, which summarises the contents of the paper and is free for re-use at meetings and presentations. Search for the article DOI on SpringerLink.com The authors have also provided an audio summary of the article, which is available to download as ESM, or to listen to via the JNC/ASNC Podcast. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12350-020-02408-6) contains supplementary material, which is available to authorized users.
Reprint requests: Jonny Nordstro¨m, PET Centre, Uppsala University Hospital, 751 85 Uppsala, Sweden; [email protected] 1071-3581/$34.00 Copyright Ó 2020 The Author(s)
J. Nordstro¨m et al Effect of PET-CT misalignment on the quantitative accuracy of cardiac
Abbreviations MBF
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