Myocardial blood flow quantification using Rubidium-82 PET

Sabine Susanna Koenders

doi:10.3990/1.9789036554046

Myocardial blood flow quantification using Rubidium-82 PET

Sabine Susanna Koenders

Research output: Thesis › PhD Thesis - Research external, graduation UT

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Abstract

Myocardial perfusion imaging (MPI) using positron emission tomography (PET) has a high diagnostic value in the detection of obstructive coronary artery disease and is growing in its use. The addition of myocardial blood flow (MBF) and myocardial flow reserve (MFR) measurements to the visual assessment of PET images is making its way into clinical routine. MBF and MFR provide valuable additional diagnostic and prognostic information about the extent and functional importance of possible stenosis to visual assessment of PET images.

The quantification of MBF is conducted with kinetic modeling of the image-derived time-activity curves (TACs) allowing derivation of MBF in units of mL/min per gram of tissue. MFR is defined as the ratio of MBF during maximal coronary vasodilatation to resting MBF. In other words, the MFR gives an indication of the degree of coronary vasodilator capacity and reflects the extent of which a stenosis actually impairs the supply of blood to the myocardium when the demand increases.

In the process of data acquisition, image reconstruction, post-processing and interpretation of quantitative myocardial PET, there are several pitfalls that can result in unreliable blood flow quantification. In order for MBF and MFR quantification to achieve its full clinical potential, the technical aspects of MBF and MFR quantification must be well understood and standardized so that reliable MBF and MFR values can be routinely produced.

The aim of this thesis was to study and optimize technical aspects to obtain reliable MBF and MFR values with Rubidium-82 (Rb-82) PET MPI. Furthermore, we studied the clinical value of MFR in clinical practice.

Original language	English
Qualification	Doctor of Philosophy
Awarding Institution	University of Twente
Supervisors/Advisors	Slump, C.H., Supervisor van Dijk, J.D., Co-Supervisor van Dalen, Jorn A., Co-Supervisor, External person
Award date	30 Sept 2022
Place of Publication	Enschede
Publisher	University of Twente
Print ISBNs	978-90-365-5404-6
DOIs	https://doi.org/10.3990/1.9789036554046
Publication status	Published - 30 Sept 2022

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Thesis S.S. KoendersFinal published version, 51.3 MB

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title = "Myocardial blood flow quantification using Rubidium-82 PET",

abstract = "Myocardial perfusion imaging (MPI) using positron emission tomography (PET) has a high diagnostic value in the detection of obstructive coronary artery disease and is growing in its use. The addition of myocardial blood flow (MBF) and myocardial flow reserve (MFR) measurements to the visual assessment of PET images is making its way into clinical routine. MBF and MFR provide valuable additional diagnostic and prognostic information about the extent and functional importance of possible stenosis to visual assessment of PET images. The quantification of MBF is conducted with kinetic modeling of the image-derived time-activity curves (TACs) allowing derivation of MBF in units of mL/min per gram of tissue. MFR is defined as the ratio of MBF during maximal coronary vasodilatation to resting MBF. In other words, the MFR gives an indication of the degree of coronary vasodilator capacity and reflects the extent of which a stenosis actually impairs the supply of blood to the myocardium when the demand increases. In the process of data acquisition, image reconstruction, post-processing and interpretation of quantitative myocardial PET, there are several pitfalls that can result in unreliable blood flow quantification. In order for MBF and MFR quantification to achieve its full clinical potential, the technical aspects of MBF and MFR quantification must be well understood and standardized so that reliable MBF and MFR values can be routinely produced. The aim of this thesis was to study and optimize technical aspects to obtain reliable MBF and MFR values with Rubidium-82 (Rb-82) PET MPI. Furthermore, we studied the clinical value of MFR in clinical practice. ",

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N2 - Myocardial perfusion imaging (MPI) using positron emission tomography (PET) has a high diagnostic value in the detection of obstructive coronary artery disease and is growing in its use. The addition of myocardial blood flow (MBF) and myocardial flow reserve (MFR) measurements to the visual assessment of PET images is making its way into clinical routine. MBF and MFR provide valuable additional diagnostic and prognostic information about the extent and functional importance of possible stenosis to visual assessment of PET images. The quantification of MBF is conducted with kinetic modeling of the image-derived time-activity curves (TACs) allowing derivation of MBF in units of mL/min per gram of tissue. MFR is defined as the ratio of MBF during maximal coronary vasodilatation to resting MBF. In other words, the MFR gives an indication of the degree of coronary vasodilator capacity and reflects the extent of which a stenosis actually impairs the supply of blood to the myocardium when the demand increases. In the process of data acquisition, image reconstruction, post-processing and interpretation of quantitative myocardial PET, there are several pitfalls that can result in unreliable blood flow quantification. In order for MBF and MFR quantification to achieve its full clinical potential, the technical aspects of MBF and MFR quantification must be well understood and standardized so that reliable MBF and MFR values can be routinely produced. The aim of this thesis was to study and optimize technical aspects to obtain reliable MBF and MFR values with Rubidium-82 (Rb-82) PET MPI. Furthermore, we studied the clinical value of MFR in clinical practice.

AB - Myocardial perfusion imaging (MPI) using positron emission tomography (PET) has a high diagnostic value in the detection of obstructive coronary artery disease and is growing in its use. The addition of myocardial blood flow (MBF) and myocardial flow reserve (MFR) measurements to the visual assessment of PET images is making its way into clinical routine. MBF and MFR provide valuable additional diagnostic and prognostic information about the extent and functional importance of possible stenosis to visual assessment of PET images. The quantification of MBF is conducted with kinetic modeling of the image-derived time-activity curves (TACs) allowing derivation of MBF in units of mL/min per gram of tissue. MFR is defined as the ratio of MBF during maximal coronary vasodilatation to resting MBF. In other words, the MFR gives an indication of the degree of coronary vasodilator capacity and reflects the extent of which a stenosis actually impairs the supply of blood to the myocardium when the demand increases. In the process of data acquisition, image reconstruction, post-processing and interpretation of quantitative myocardial PET, there are several pitfalls that can result in unreliable blood flow quantification. In order for MBF and MFR quantification to achieve its full clinical potential, the technical aspects of MBF and MFR quantification must be well understood and standardized so that reliable MBF and MFR values can be routinely produced. The aim of this thesis was to study and optimize technical aspects to obtain reliable MBF and MFR values with Rubidium-82 (Rb-82) PET MPI. Furthermore, we studied the clinical value of MFR in clinical practice.

U2 - 10.3990/1.9789036554046

DO - 10.3990/1.9789036554046

M3 - PhD Thesis - Research external, graduation UT

SN - 978-90-365-5404-6

PB - University of Twente

CY - Enschede

ER -

Myocardial blood flow quantification using Rubidium-82 PET

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