Simplified quantification of 13N-ammonia PET myocardial blood flow: A comparative study with the standard compartment model to facilitate clinical use

J Nucl Cardiol. 2020 Jun;27(3):819-828. doi: 10.1007/s12350-018-1450-1. Epub 2018 Oct 15.

Abstract

Background: Short imaging protocol to quantify myocardial blood flow (MBF) and myocardial flow reserve (MFR) may enhance the clinical application of 13N-ammonia cardiac PET. We assessed the flow quantitation of 13N-ammonia PET implementing simple retention model and two-compartment model.

Methods: Fourteen healthy volunteers (HVT) and twenty-three clinical patients received 13N-ammonia PET/CT. The simple retention model used the first 7-minute image to quantify MBF. Global and regional MBF and MFR of the two models were compared.

Results: Global and regional MBF and MFR of these two models were highly correlated with mildly inferior correlation in RCA territory (global R2: rest MBF = 0.79, stress MBF = 0.65, MFR = 0.77; regional R2: rest MBF ≥ 0.72, stress MBF ≥ 0.52, MFR ≥ 0.68). There were significant differences for MFR (4.04 ± 0.72, 3.66 ± 0.48, p = .02) and rest MBF (0.69 ± 0.12, 0.78 ± 0.12, p = .02) between the two models in the HVT group.

Conclusions: 13N-ammonia global and regional MBF and MFR from the simple retention model demonstrate strong correlations with that from the two-compartment model. Significant differences of MFR and rest MBF are noted in the HVT group, with a proposed normal reference value for the 13N-ammonia short simple retention protocol.

Keywords: 13N-ammonia PET; Myocardial blood flow quantitation; coronary artery disease; simple retention model; two-compartment model.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Ammonia
  • Arteries / diagnostic imaging
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Circulation*
  • Female
  • Fractional Flow Reserve, Myocardial
  • Heart / diagnostic imaging*
  • Heart / physiopathology*
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Middle Aged
  • Myocardial Perfusion Imaging / methods
  • Myocardium
  • Nitrogen Radioisotopes*
  • Positron Emission Tomography Computed Tomography / methods*
  • Radiopharmaceuticals

Substances

  • Nitrogen Radioisotopes
  • Nitrogen-13
  • Radiopharmaceuticals
  • Ammonia