Myocardial Blood Flow Quantification for Evaluation of Coronary Artery Disease by Positron Emission Tomography, Cardiac Magnetic Resonance Imaging, and Computed Tomography

Waller, Alfonso H.; Blankstein, Ron; Kwong, Raymond Y.; Carli, Marcelo F. Di

doi:10.1007/s11886-014-0483-6

Cited by 24 publications

(18 citation statements)

References 103 publications

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“…Coronary blood flow measurements may help in assessing the prognosis and for monitoring the effectiveness of risk reduction strategies [36, 75, 76]. …”

Section: Importance Of Absolute Coronary Blood Flow Measurementsmentioning

confidence: 99%

Assessing Coronary Blood Flow Physiology in the Cardiac Catheterisation Laboratory

Vijayan

Barmby

Pearson

et al. 2017

CCR

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Background:Contemporary management of coronary disease focuses on the treatment of stenoses in the major epicardial vessels. However, myocardial blood flow is known to be contingent on a range of factors in addition to the patency of the epicardial vessels. These include anatomical and physiological factors such as the extent of myocardium supplied by the vessel, systemic blood pres-sure, the natural variation in vascular tone in response to physiological needs which allows for coro-nary autoregulation and pathological factors such as the presence of downstream obstruction to flow due to disease of the small coronary vessels or myocardium. The assessment of clinical effectiveness and adequacy of coronary revascularisation requires the ability to comprehensively and accurately as-sess and measure myocardial perfusion.Conclusion:In this article, we review the current methods of evaluating coronary blood flow and my-ocardial perfusion in the cardiac catheterisation laboratory.

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“…Coronary blood flow measurements may help in assessing the prognosis and for monitoring the effectiveness of risk reduction strategies [36, 75, 76]. …”

Section: Importance Of Absolute Coronary Blood Flow Measurementsmentioning

confidence: 99%

Assessing Coronary Blood Flow Physiology in the Cardiac Catheterisation Laboratory

Vijayan

Barmby

Pearson

et al. 2017

CCR

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“…This has been shown to aid in the real-world diagnosis of CAD in addition to prognostication. [39][40][41][42] In one study of 2,783 patients referred for rest/stress PET for assessment of CAD, quantification of MBF conferred incremental risk stratification over semiquantitative assessment of ischemia.…”

Section: Assessment Of Cadmentioning

confidence: 99%

Diagnostic usefulness of myocardial perfusion imaging in patients reluctant to undergo angiography

Narang¹,

Singh²,

Patel³

2016

RRCC

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Abstract:Patients with known or suspected coronary artery disease are often referred for ischemic testing to aid in risk assessment and guide management when symptoms develop. Invasive coronary angiography and percutaneous intervention are typically reserved for patients with symptoms refractory to medical management. The use of noninvasive modalities with myocardial perfusion imaging is a powerful diagnostic and prognostic tool for patients reluctant to undergo angiography. This review focuses on evaluation of coronary artery disease with myocardial perfusion imaging using single-photon emission computerized tomography, positron emission tomography, myocardial contrast echocardiography, cardiovascular magnetic resonance, and cardiovascular computerized tomography.

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“…6 Significant technical developments in recent years have increased the awareness of the clinical value of MBF quantification in humans. 6, 7 Recently, a number of studies using a dedicated cardiac SPECT camera were performed to calculate myocardial perfusion index (MPI) and CFR using commonly available SPECT radiotracers. 8-10 …”

Section: Introductionmentioning

confidence: 99%

Measurement of absolute myocardial blood flow in humans using dynamic cardiac SPECT and 99mTc-tetrofosmin: Method and validation

Shrestha

Sciammarella

Alhassen

et al. 2017

Journal of Nuclear Cardiology

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Background The objective of this study was to measure myocardial blood flow (MBF) in humans using 99mTc-tetrofosmin and dynamic single photon emission computed tomography (SPECT). Methods Dynamic SPECT using 99mTc-tetrofosmin and dynamic positron emission tomography (PET) was performed on a group of 16 patients. The SPECT data were reconstructed using a 4D-spatiotemporal iterative reconstruction method. The data corresponding to 9 patients were used to determine the flow-extraction curve for 99mTc-tefrofosmin while data from the remaining 7 patients were used for method validation. The nonlinear tracer correction parameters A and B for 99mTc-tefrofosmin were estimated for the 9 patients by fitting the flow-extraction curve K1=Ftrue(1−Aexptrue(−BFtrue)true) for K1 values estimated with 99mTc-tefrofosmin using SPECT and MBF values estimated with 13N-NH3 using PET. These parameters were then used to calculate MBF and coronary flow reserve (CFR) in three coronary territories (LAD, RCA, and LCX) using SPECT for an independent cohort of 7 patients. The results were then compared with that estimated with 13N-NH3 PET. The flow dependent permeability surface-area product (PS) for 99mTc-tefrofosmin was also estimated. Results The estimated flow extraction parameters for 99mTc-tefrofosmin was found to be A=0.91±0.11, B=0.34±0.20 (R2 = 0.49). The range of MBF in LAD, RCA, and LCX was 0.44 ml/min/g to 3.81 ml/min/g. The MBF between PET and SPECT in the group of independent cohort of 7 patients showed statistically significant correlation, r = 0.71 (p < 0.001). However, the corresponding CFR correlation was moderate r = 0.39 yet statistically significant (p = 0.037). The PS for 99mTc-tefrofosmin was (0.091 ± 0.10) * MBF = (0.32 ± 0.16). Conclusions Dynamic cardiac SPECT using 99mTc-tetrofosmin and a clinical two-headed SPECT/CT scanner can be a useful tool for estimation of MBF.

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Myocardial Blood Flow Quantification for Evaluation of Coronary Artery Disease by Positron Emission Tomography, Cardiac Magnetic Resonance Imaging, and Computed Tomography

Cited by 24 publications

References 103 publications

Assessing Coronary Blood Flow Physiology in the Cardiac Catheterisation Laboratory

Assessing Coronary Blood Flow Physiology in the Cardiac Catheterisation Laboratory

Diagnostic usefulness of myocardial perfusion imaging in patients reluctant to undergo angiography

Measurement of absolute myocardial blood flow in humans using dynamic cardiac SPECT and 99mTc-tetrofosmin: Method and validation

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