Selection of PET Camera and Implications on the Reliability and Accuracy of Absolute Myocardial Blood Flow Quantificatio
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NUCLEAR CARDIOLOGY (V DILSIZIAN, SECTION EDITOR)
Selection of PET Camera and Implications on the Reliability and Accuracy of Absolute Myocardial Blood Flow Quantification Ran Klein 1,2 & Robert A. deKemp 3,4
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review PET scanner design and performance evaluation has been driven historically by the imaging requirements for whole-body imaging in oncology. Cardiac PET imaging for accurate quantification of myocardial blood flow (MBF) using shortlived tracers such as rubidium-82 imposes additional requirements for wide dynamic range and high count-rate accuracy. This paper examines the technical challenges encountered in cardiac imaging of myocardial perfusion and blood flow quantification. Recent Findings The newest PET-CT scanners using digital silicon photomultiplier technology have high absolute sensitivity (4– 20%) and time-of-flight resolution (3–7 cm) which further improves image quality. The concept of “integral” noise equivalent counts (iNEC) is introduced to compare scanner count-rate performance over the wide dynamic range encountered in MBF imaging with rubidium-82. Summary The latest-generation digital PET scanners with wide axial field-of-view and enhanced time-of-flight resolution should enable accurate quantification of MBF, without any compromise in the quality of conventional ECG-gated myocardial perfusion images. Keywords Positron emission tomography . Myocardial blood flow . Myocardial perfusion imaging . Scanner performance
Introduction Absolute quantification of myocardial blood flow (MBF) and flow reserve (MFR) with positron emission tomography (PET) has been well validated and its incremental clinical value over myocardial perfusion imaging (MPI) continues to be demonstrated in recent literature [1–4]. Furthermore, with optimized image acquisition protocols consisting of dynamic This article is part of the Topical Collection on Nuclear Cardiology * Robert A. deKemp [email protected] Ran Klein [email protected] 1
Division of Nuclear Medicine, Department of Medicine, University of Ottawa, Ottawa, Canada
2
Department of Nuclear Medicine, The Ottawa Hospital, Ottawa, Canada
3
Division of Cardiology, Department of Medicine, University of Ottawa, Ottawa, Canada
4
National Cardiac PET Centre, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, ON K1Y 4W7, Canada
imaging from the time of tracer administration to stable biodistribution, MBF quantification is possible on current PET systems with no additional imaging time, radiation exposure, or costs [5]. Consequently, MBF has been embraced by the American Society of Nuclear Cardiology and the Society of Nuclear Medicine and Molecular Imaging [6, 7] and is increasingly being adopted in the clinical routine. The recent surge of interest in MBF imaging has been enabled by commercial availability of high count-rate PET scanners, robust image analysis software [8, 9], and professional guidelines for implementation of MBF protocols and interpretation o
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