A1 Refereed original research article in a scientific journal

Quantification of myocardial blood flow using Tl-201 SPECT and population-based input function




AuthorsKoshino K, Fukushima K, Fukumoto M, Hori Y, Moriguchi T, Zeniya T, Nishimura Y, Kiso K, Iida H

PublisherSPRINGER

Publication year2014

JournalAnnals of Nuclear Medicine

Journal name in sourceANNALS OF NUCLEAR MEDICINE

Journal acronymANN NUCL MED

Volume28

Issue9

First page 917

Last page925

Number of pages9

ISSN0914-7187

DOIhttps://doi.org/10.1007/s12149-014-0888-8


Abstract
Objectives Thallium-201 (Tl-201) single photon emission computed tomography (SPECT) is an important tool in the diagnosis of ischemic heart disease. Absolute quantification of myocardial blood flow (MBF) has the potential to provide more useful information on myocardial perfusion than semi-quantitative assessments. This study aimed to validate the quantification of MBF using Tl-201 cardiac SPECT based on a population-averaged input function (STD-IF) and one-point blood sample technique.Methods Tl-201 emission and computed tomography (CT)-based attenuation scans were performed on 11 healthy volunteers at rest using a SPECT/CT scanner. Individual input functions (IND-IFs) during the emission scans were based on arterial blood samples. The STD-IF technique was validated as follows: (1) optimal time to calibrate a STD-IF was determined to minimize differences between the calibrated STD-IF and the IND-IFs. (2) Tissue time-activity curves (TTACs) were generated based on a single-tissue compartment model for MBFtrue = 0.5, 1.0, 1.5, and 2.0 mL/min/g, a constant distribution volume of 45 mL/mL, and IND-IFs. The pseudo STD-IF for each subject was generated using the leave-one-out technique. Using the optimal calibration time and the pseudo STD-IFs, MBF values were estimated on the TTACs with an autoradiography method. Optimal mid-scan time (MST) with a fixed duration of 20 min was determined to minimize intersubject variation in estimated MBF errors, and (3) Global and regional MBF values estimated with pseudo STD-IFs were compared to those with IND-IFs using the optimal calibration time and MST.Results The optimal calibration time and MST were both 20 min after Tl-201 injection. Global MBF determined using both IND-IFs and pseudo STD-IF showed significant correlations with rate-pressure products, R-2 = 0.645; p < 0.01 and (true) = 0.303; p < 0.05, respectively. The mean percent error in regional MBF using pseudo STD-IFs was 0.69 +/- 7.80 % (-12.80 to 14.25 %). No significant difference was observed between regional MBF values using IND-IFs and pseudo STD-IFs.Conclusion This study demonstrated that the proposed technique based on a STD-IF and one-point blood sample provided hemodynamically reasonable global MBF values and the regional MBF values comparable to those with IND-IFs.



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