BACKGROUND: Non-invasive approaches to investigate myocardial efficiency can help track the progression of heart failure (HF). This study evaluates the repeatability and reproducibility of 11C-acetate positron emission tomography (PET) imaging of oxidative metabolism. METHODS AND RESULTS: Dynamic 11C-acetate PET scans were performed at baseline and followup (47 ± 22 days apart) in 20 patients with stable HF with reduced ejection fraction. Two observers blinded to patients' clinical data used FlowQuant® to evaluate test-retest repeatability, as well as intra- and inter-observer reproducibility of 11C-acetate tracer uptake and clearance rates, for the measurement of myocardial oxygen consumption (MVO2), myocardial external efficiency (MEE), work metabolic index (WMI), and myocardial blood flow. Reproducibility and repeatability were evaluated using intra-class-correlation (ICC) and Bland-Altman coefficient-of-repeatability (CR). Test-retest correlations and repeatability were better for MEE and WMI compared to MVO2. All intra- and inter-observer correlations were excellent (ICC = 0.95-0.99) and the reproducibility values (CR = 3%-6%) were significantly lower than the test-retest repeatability values (22%-54%, P < 0.001). Repeatability was improved for all parameters using a newer PET-computed tomography (CT) scanner compared to older PET-only instrumentation. CONCLUSION: 11C-acetate PET measurements of WMI and MEE exhibited excellent test-retest repeatability and operator reproducibility. Newer PET-CT scanners may be preferred for longitudinal tracking of cardiac efficiency.
BACKGROUND: Non-invasive approaches to investigate myocardial efficiency can help track the progression of heart failure (HF). This study evaluates the repeatability and reproducibility of 11C-acetate positron emission tomography (PET) imaging of oxidative metabolism. METHODS AND RESULTS: Dynamic 11C-acetate PET scans were performed at baseline and followup (47 ± 22 days apart) in 20 patients with stable HF with reduced ejection fraction. Two observers blinded to patients' clinical data used FlowQuant® to evaluate test-retest repeatability, as well as intra- and inter-observer reproducibility of 11C-acetate tracer uptake and clearance rates, for the measurement of myocardial oxygen consumption (MVO2), myocardial external efficiency (MEE), work metabolic index (WMI), and myocardial blood flow. Reproducibility and repeatability were evaluated using intra-class-correlation (ICC) and Bland-Altman coefficient-of-repeatability (CR). Test-retest correlations and repeatability were better for MEE and WMI compared to MVO2. All intra- and inter-observer correlations were excellent (ICC = 0.95-0.99) and the reproducibility values (CR = 3%-6%) were significantly lower than the test-retest repeatability values (22%-54%, P < 0.001). Repeatability was improved for all parameters using a newer PET-computed tomography (CT) scanner compared to older PET-only instrumentation. CONCLUSION:11C-acetate PET measurements of WMI and MEE exhibited excellent test-retest repeatability and operator reproducibility. Newer PET-CT scanners may be preferred for longitudinal tracking of cardiac efficiency.
Authors: Paul Knaapen; Tjeerd Germans; Juhani Knuuti; Walter J Paulus; Pieter A Dijkmans; Cornelis P Allaart; Adriaan A Lammertsma; Frans C Visser Journal: Circulation Date: 2007-02-20 Impact factor: 29.690
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Authors: K T Sun; L A Yeatman; D B Buxton; K Chen; J A Johnson; S C Huang; K F Kofoed; S Weismueller; J Czernin; M E Phelps; H R Schelbert Journal: J Nucl Med Date: 1998-02 Impact factor: 10.057
Authors: R S Beanlands; D S Bach; R Raylman; W F Armstrong; V Wilson; M Montieth; C K Moore; E Bates; M Schwaiger Journal: J Am Coll Cardiol Date: 1993-11-01 Impact factor: 24.094
Authors: Stefan A J Timmer; Tjeerd Germans; Marco J W Götte; Iris K Rüssel; Pieter A Dijkmans; Mark Lubberink; Jurrien M ten Berg; Folkert J ten Cate; Adriaan A Lammertsma; Paul Knaapen; Albert C van Rossum Journal: Eur J Nucl Med Mol Imaging Date: 2010-01-13 Impact factor: 9.236
Authors: S A J Timmer; M Lubberink; T Germans; M J W Götte; J M ten Berg; F J ten Cate; A C van Rossum; A A Lammertsma; P Knaapen Journal: J Nucl Cardiol Date: 2009-12-29 Impact factor: 5.952