Influence of different time framings, reconstruction algorithms and post-processing methods on the quantification of myocardial blood flow from 13 N-NH 3 PET images

• Published in: Clinical physiology and functional imaging 2024-03, Vol.44 (2), p.154-163
• Main Authors: Akil, Shahnaz, Székely, Anna E, Hedeer, Fredrik, Olsson, Berit, Engblom, Henrik, Hindorf, Cecilia
• Format: Article
• Language: English
• ISSN: 1475-0961; 1475-097X
• DOI: 10.1111/cpf.12861

The aim was to investigate to what extent the quantification of myocardial blood flow (MBF) from dynamic N-NH positron emission tomography (PET) images is affected by time frame schemes, time-of-flight (ToF), reconstruction algorithms, blood pool volume of interest (VOI) locations and compartment models in patients with suspected chronic coronary syndrome. A standard MBF value was determined from 25 patients' rest/stress N-NH PET/CT images reconstructed with ordered subset expectation maximization (OSEM), 5 s time frame for the first frames without ToF, subsequently analyzed using a basal VOI and the deGrado compartment model. MBFs calculated using 2 or 10 s for the first frames, ToF, block-sequential regularized expectation maximization (BSREM), apical or large VOI, Hutchins or Krivokapich compartment models were compared to MBF in Bland-Altman plots (bias ± SD). Good agreement in global rest/stress MBF (mL/min/g) was found when changing the time frame scheme or reconstruction algorithm (MBF vs. MBF : -0.02 ± 0.06; MBF : 0.01 ± 0.07; MBF : 0.01 ± 0.07), while a lower level of agreement was found when altering the other factors (MBF vs. MBF : -0.07 ± 0.10; MBF : -0.27 ± 0.25; MBF : -0.11 ± 0.10; MBF : -0.08 ± 0.10; MBF : -0.47 ± 0.50). Quantification of MBF from N-NH PET images is more affected by choice of compartment models, ToF and blood pool VOIs than by different time frame schemes and reconstruction algorithms.