Triple-gated motion and blood pool clearance corrections improve reproducibility of coronary 18F-NaF PET

• Published in: European journal of nuclear medicine and molecular imaging 2019-11, Vol.46 (12), p.2610-2620
• Main Authors: Lassen, Martin Lyngby, Kwiecinski, Jacek, Dey, Damini, Cadet, Sebastien, Germano, Guido, Berman, Daniel S., Adamson, Philip D., Moss, Alastair J., Dweck, Marc R., Newby, David E., Slomka, Piotr J.
• Format: Article
• Language: English
• Subjects: Angiography; Blood; Cardiology; Cardiovascular disease; Coefficients; Computed tomography; Coronary artery; Coronary artery disease; Datasets; Emission analysis; Fluorides; Fluorine isotopes; Heart; Heart diseases; Image acquisition; Image reconstruction; Imaging; Lesions; Measurement methods; Medical imaging; Medicine; Medicine & Public Health; Nuclear Medicine; Oncology; Original Article; Orthopedics; Positron emission; Positron emission tomography; Radiology; Reproducibility; Sodium; Sodium fluoride; Tomography
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-019-04437-x

Purpose To improve the test–retest reproducibility of coronary plaque 18 F-sodium fluoride ( 18 F-NaF) positron emission tomography (PET) uptake measurements. Methods We recruited 20 patients with coronary artery disease who underwent repeated hybrid PET/CT angiography (CTA) imaging within 3 weeks. All patients had 30-min PET acquisition and CTA during a single imaging session. Five PET image-sets with progressive motion correction were reconstructed: (i) a static dataset (no-MC), (ii) end-diastolic PET (standard), (iii) cardiac motion corrected (MC), (iv) combined cardiac and gross patient motion corrected (2 × MC) and, (v) cardiorespiratory and gross patient motion corrected (3 × MC). In addition to motion correction, all datasets were corrected for variations in the background activities which are introduced by variations in the injection-to-scan delays (background blood pool clearance correction, BC). Test–retest reproducibility of PET target-to-background ratio (TBR) was assessed by Bland–Altman analysis and coefficient of reproducibility. Results A total of 47 unique coronary lesions were identified on CTA. Motion correction in combination with BC improved the PET TBR test–retest reproducibility for all lesions (coefficient of reproducibility: standard = 0.437, no-MC = 0.345 (27% improvement), standard + BC = 0.365 (20% improvement), no-MC + BC = 0.341 (27% improvement), MC + BC = 0.288 (52% improvement), 2 × MC + BC = 0.278 (57% improvement) and 3 × C + BC = 0.254 (72% improvement), all p   10 mm following corrections, reproducibility was improved by 133% (coefficient of reproducibility: standard = 0.745, 3 × MC = 0.320). Conclusion Joint corrections for cardiac, respiratory, and gross patient motion in combination with background blood pool corrections markedly improve test–retest reproducibility of coronary 18 F-NaF PET.