open access
Assessment of the myocardial FDG-PET image quality with the use of maximal Standardized Uptake Value myocardial to background index. Application of the results in regard to semiquantitative assessment of myocardial viability with cardiac dedicated softwar
Affiliations- Nuclear Medicine Department, Medical University of Warsaw, Banacha 1a, 02–097 Warsaw, Poland
- Ist Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02–097 Warsaw, Poland
- Department of Cardiac Surgery, I Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02–097 Warsaw, Poland
open access
Abstract
BACKGROUND: The objective of this study was to semiquantitatively assess the degree of myocardial fluorodeoxyglucose (FDG) uptake in glucose-loaded myocardial viability positron emission tomography/computed tomography (PET/CT) scans, to calculate the myocardial to background index, and correlate the index with image quality assessed on the basis of visual qualitative assessment.
MATERIAL AND METHODS: The myocardial FDG-PET/CT study was carried out in 69 non-diabetic patients, who had known coronary artery disease, by intravenous injection of 250 ± 70 MBq (range: 180–320 MBq) FDG. Images were interpreted visually and patients were divided into three groups according to the grade of myocardial uptake: optimal, suboptimal, and uninterpretable. Semiquantitative analysis was performed by calculating the standardized uptake value (SUVmax) for myocardium and background (blood pool) activity, and expressed as the myocardial to background (M/B) activity ratio.
RESULTS: On the basis of visual (qualitative) analysis, 60/69 (86.96%) patients showed optimal quality of FDG cardiac uptake, 3/69 (4.35%) were suboptimal, and uninterpretable FDG PET scan results were found in 6/69 (8.70%) patients. The M/B index was found to be significantly higher in images of optimal vs. suboptimal quality (6.87 ± 3.99 vs. 1.65 ± 0.78 respectively; p < 0.0001).
CONCLUSIONS: The index ratio of 2.2, which is consistent with the upper borderline value for visually uninterpretable images, was considered the cut-off value for scans of optimal and non-optimal quality.
Abstract
BACKGROUND: The objective of this study was to semiquantitatively assess the degree of myocardial fluorodeoxyglucose (FDG) uptake in glucose-loaded myocardial viability positron emission tomography/computed tomography (PET/CT) scans, to calculate the myocardial to background index, and correlate the index with image quality assessed on the basis of visual qualitative assessment.
MATERIAL AND METHODS: The myocardial FDG-PET/CT study was carried out in 69 non-diabetic patients, who had known coronary artery disease, by intravenous injection of 250 ± 70 MBq (range: 180–320 MBq) FDG. Images were interpreted visually and patients were divided into three groups according to the grade of myocardial uptake: optimal, suboptimal, and uninterpretable. Semiquantitative analysis was performed by calculating the standardized uptake value (SUVmax) for myocardium and background (blood pool) activity, and expressed as the myocardial to background (M/B) activity ratio.
RESULTS: On the basis of visual (qualitative) analysis, 60/69 (86.96%) patients showed optimal quality of FDG cardiac uptake, 3/69 (4.35%) were suboptimal, and uninterpretable FDG PET scan results were found in 6/69 (8.70%) patients. The M/B index was found to be significantly higher in images of optimal vs. suboptimal quality (6.87 ± 3.99 vs. 1.65 ± 0.78 respectively; p < 0.0001).
CONCLUSIONS: The index ratio of 2.2, which is consistent with the upper borderline value for visually uninterpretable images, was considered the cut-off value for scans of optimal and non-optimal quality.
Keywords
fluorodeoxyglucose-positron emission tomography, SUVmax, myocardial to background ratio, myocardial uptake, myocardial viability
About this articleTitle
Assessment of the myocardial FDG-PET image quality with the use of maximal Standardized Uptake Value myocardial to background index. Application of the results in regard to semiquantitative assessment of myocardial viability with cardiac dedicated softwar
Journal
Issue
Article type
Research paper
Pages
69-75
Published online
2017-02-15
Page views
1374
Article views/downloads
1732
DOI
Pubmed
Bibliographic record
Nucl. Med. Rev 2017;20(2):69-75.
Keywords
fluorodeoxyglucose-positron emission tomography
SUVmax
myocardial to background ratio
myocardial uptake
myocardial viability
Authors
Małgorzata Kobylecka
Tomasz Mazurek
Katarzyna Fronczewska-Wieniawska
Anna Fojt
Anna Słowikowska
Joanna Mączewska
Marek Chojnowski
Adam Bajera
Maria Teresa Płazińska
Leszek Królicki
References (20)- Brogsitter C, Grüning T, Weise R, et al. 18F-FDG PET for detecting myocardial viability: validation of 3D data acquisition. J Nucl Med. 2005; 46(1): 19–24.
- Maes AF, Borgers M, Flameng W, et al. Assessment of Myocardial Viability in Chronic Coronary Artery Disease Using Technetium-99m Sestamibi SPECT:. Journal of the American College of Cardiology. 1997; 29(1): 62–68.
- Kobylecka M, Płazińska MT, Mazurek T, et al. Simplified protocol of cardiac 18F-fluorodeoxyglucose positron emission tomography viability study in normoglycemic patients with known coronary artery disease. Clin Imaging. 2015; 39(4): 592–596.
- Mazurek T, Kobylecka M, Zielenkiewicz M, et al. PET/CT evaluation of (18)F-FDG uptake in pericoronary adipose tissue in patients with stable coronary artery disease: Independent predictor of atherosclerotic lesions' formation? J Nucl Cardiol. 2016 [Epub ahead of print].
- Landoni C, Lucignani G, Paolini G, et al. Assessment of CABG-related risk in patients with CAD and LVD. Contribution of PET with [18F]FDG to the assessment of myocardial viability. J Cardiovasc Surg (Torino). 1999; 40(3): 363–372.
- Dweck MR, Chow MWL, Joshi NV, et al. Coronary arterial 18F-sodium fluoride uptake: a novel marker of plaque biology. J Am Coll Cardiol. 2012; 59(17): 1539–1548.
- Rahbar K, Seifarth H, Schäfers M, et al. Differentiation of malignant and benign cardiac tumors using 18F-FDG PET/CT. J Nucl Med. 2012; 53(6): 856–863.
- Ahmadian A, Brogan A, Berman J, et al. Quantitative interpretation of FDG PET/CT with myocardial perfusion imaging increases diagnostic information in the evaluation of cardiac sarcoidosis. J Nucl Cardiol. 2014; 21(5): 925–939.
- Mazurek T. [Proinflammatory capacity of adipose tissue--a new insights in the pathophysiology of atherosclerosis]. Kardiol Pol. 2009; 67(10): 1119–1124.
- Mazurek T, Kochman J, Kobylecka M, et al. Inflammatory activity of pericoronary adipose tissue may affect plaque composition in patients with acute coronary syndrome without persistent ST-segment elevation: preliminary results. Kardiol Pol. 2014; 72(5): 410–416.
- Coulden R, Chung P, Sonnex E, et al. Suppression of myocardial 18F-FDG uptake with a preparatory "Atkins-style" low-carbohydrate diet. Eur Radiol. 2012; 22(10): 2221–2228.
- Bax JJ, Veening MA, Visser FC, et al. Optimal metabolic conditions during fluorine-18 fluorodeoxyglucose imaging; a comparative study using different protocols. European Journal of Nuclear Medicine. 1997; 24(1): 35–41.
- Machac J, Bacharach SL, Bateman TM, et al. Quality Assurance Committee of the American Society of Nuclear Cardiology. Positron emission tomography myocardial perfusion and glucose metabolism imaging. J Nucl Cardiol. 2006; 13(6): e121–e151.
- de Groot M, Meeuwis APW, Kok PJM, et al. Influence of blood glucose level, age and fasting period on non-pathological FDG uptake in heart and gut. Eur J Nucl Med Mol Imaging. 2005; 32(1): 98–101.
- Kaneta T, Hakamatsuka T, Takanami K, et al. Evaluation of the relationship between physiological FDG uptake in the heart and age, blood glucose level, fasting period, and hospitalization. Ann Nucl Med. 2006; 20(3): 203–208.
- Ishimaru S, Tsujino I, Takei T, et al. Focal uptake on 18F-fluoro-2-deoxyglucose positron emission tomography images indicates cardiac involvement of sarcoidosis. Eur Heart J. 2005; 26(15): 1538–1543.
- Ohira H, Tsujino I, Yoshinaga K. ¹⁸F-Fluoro-2-deoxyglucose positron emission tomography in cardiac sarcoidosis. Eur J Nucl Med Mol Imaging. 2011; 38(9): 1773–1783.
- Paquet N, Albert A, Foidart J, et al. Within-patient variability of (18)F-FDG: standardized uptake values in normal tissues. J Nucl Med. 2004; 45(5): 784–788.
- Brogsitter C, Grüning T, Weise R, et al. 18F-FDG PET for detecting myocardial viability: validation of 3D data acquisition. J Nucl Med. 2005; 46(1): 19–24.
- Israel O, Weiler-Sagie M, Rispler S, et al. PET/CT quantitation of the effect of patient-related factors on cardiac 18F-FDG uptake. J Nucl Med. 2007; 48(2): 234–239.
