Vessel-specific quantification of absolute myocardial blood flow, myocardial flow reserve and relative flow reserve by m
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Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA Department of Nuclear Medicine, Chonnam National University, Gwangju, Korea Nuclear Cardiology Department, Instituto Nacional de Cardiologia, Mexico City, Mexico Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Korea Department of Biostatistics & Bioinformatics, Rollins School of Public Health, Emory University, Atlanta Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
Received Jul 17, 2018; accepted Sep 15, 2018 doi:10.1007/s12350-018-01472-3
Objectives. The goal of the present work is to present a novel methodology for the extraction of MBF, MFR and RFR along coronary arteries by means of multimodality image fusion of dynamic PET and CCTA images. Background. FFR is the reference standard to identify flow-limiting lesions, but its invasiveness limits broad application. New noninvasive methodologies are warranted to stratify patients and guide treatment. Methods. A group of 16 low-risk CAD subjects who underwent both 13NH3 PET and CCTA were analyzed. Image fusion techniques were employed to align the studies and CCTA-derived anatomy used to identify coronaries trajectories. MBF was calculated by means of a 1-tissue compartmental model for the standard vascular territories and along patient-specific vessel paths from the base to the apex of the heart. Results. Low-risk ranges for MBF. MFR and RFR for LAD, LCX and rPDA were computed for the entire cohort and separated by gender. Computed low-risk ranges were used to assess a prospective patient with suspected CAD. Conclusions. Our vessel-specific functional indexes and 3D displays offer promise to more closely replicate what is commonly performed during a catheterization session and have the Electronic supplementary material The online version of this article (doi:https://doi.org/10.1007/s12350-018-01472-3) contains supplementary material, which is available to authorized users. 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.
Reprint requests: Marina Piccinellis, PhD, Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd, NE, Atlanta, GA, 30322; [email protected] 1071-3581/$34.00 Copyright Ó 2018 American Society of Nuclear Cardiology.
Piccinelli et al Vessel-specific quantification of absolute myocardial blood flow
Journal of Nuclear CardiologyÒ
potential of providing effective noninvasive tools for the identification of flow-limiting lesions and image-guided therapy. (J Nucl Cardiol 2018) Key Words: CAD Æ multimodality Æ PET Æ CT Æ myocardial blood flow Æ image-guided application Abbreviations CAD Coronary artery disease CCTA Coronary computed tomographic angiography ECG Electrocardiogram FFR Fractional flow reserve ICA Invasive coronary angio
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