Abstract
Background
Positron emission tomography (PET) myocardial perfusion imaging (MPI) can be used to evaluate left ventricular (LV) volumes and function. We performed a head-to-head comparison of LV function and volumes obtained simultaneously using [13N]-ammonia-PET and cardiac magnetic resonance (CMR), with the latter serving as the reference standard.
Methods and Results
In this prospective study, 51 patients underwent [13N]-ammonia-PET MPI and CMR using a hybrid PET/MR device. Left ventricular end-systolic volumes (LVESV), end-diastolic volumes (LVEDV), stroke volumes (LVSV), ejection fractions (LVEF), and segmental wall motion were analyzed for both methods and were compared using correlational and Bland-Altman (BA) analysis; segmental wall motion was compared using ANOVA. The agreement between [13N]-ammonia-PET and CMR for LVEF was good, with minimal bias (− .6%) and narrow BA limits of agreement (− 7.9% to 6.8%), but [13N]-ammonia-PET systematically underestimated LV volumes, with high bias in LVESV (− 11.2 ml), LVEDV (− 28.9 ml), and LVSV (− 17.5 ml). Mean segmental wall motion in [13N]-ammonia-PET differed significantly among the corresponding normokinetic (6.6 ± 2 mm), hypokinetic (5.1 ± 2 mm), and akinetic (3.3 ± 2 mm) segments in CMR (P < .01).
Conclusion
LVEF and LV wall motion can be accurately assessed using [13N]-ammonia-PET MPI, although LV volumes are significantly underestimated compared to CMR.
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- CMR:
-
Cardiac magnet resonance tomography
- LV:
-
Left ventricle
- LVEDV:
-
Left ventricular end-diastolic volume
- LVEF:
-
Left ventricular ejection fraction
- LVESV:
-
Left ventricular end-systolic volume
- LVSV:
-
Left ventricular stroke volume
- MBq:
-
Megabecquerel
- MR:
-
Magnetic resonance
- PET:
-
Positron emission tomography
- SPECT:
-
Single photon emission computed tomography
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Acknowledgments
The authors would like to thank Freya Klein, Marlena Hofbauer, Melanie Thüringer, Michele Hug, and Sabrina Epp for their excellent support.
Funding
This work was supported by a grant from the Swiss National Science Foundation (SNSF, Project No. 175640) and the Iten-Kohaut Foundation.
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The authors—Alexander Maurer, Aleksandra Sustar, Hannes Grünig, Adam Bakula, Dimitri Patriki, Elia von Felten, Michael Messerli, Aju P Pazhenkottil, Andreas A Giannopoulos, Catherine Gebhard, Philipp A Kaufmann, and Tobias A Fuchs—have no personal conflicts of interest to declare. Ronny R Buechel has received honoraria from Pfizer and GE Healthcare. The University Hospital Zurich holds a research agreement with GE Healthcare.
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Supplement 1:
Scatterplots with linear correlation and regression analysis of underestimation of LV volumes in [13N]-ammonia-PET MPI relative to CMR as a function of estimated heart size (CMR LVEDV). a), b) & c) show the significant increasing underestimation of LV volume in [13N]-ammonia-PET MPI for increasing heart size for LVESV, LVEDV and LVSV respectively. Supplementary file2 (DOCX 286 kb)
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Maurer, A., Sustar, A., Giannopoulos, A.A. et al. Left ventricular function and volumes from gated [13N]-ammonia positron emission tomography myocardial perfusion imaging: A prospective head-to-head comparison against CMR using a hybrid PET/MR device. J. Nucl. Cardiol. 30, 616–625 (2023). https://doi.org/10.1007/s12350-022-03029-x
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DOI: https://doi.org/10.1007/s12350-022-03029-x