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. 2020 Jun;27(3):962-972.
doi: 10.1007/s12350-018-01542-6. Epub 2018 Nov 29.

Analytical quantification of aortic valve 18F-sodium fluoride PET uptake

Daniele Massera  1 , Mhairi K Doris  2 , Sebastien Cadet  3 , Jacek Kwiecinski  2   3 , Tania A Pawade  2 , Frederique E C M Peeters  4 , Damini Dey  3 , David E Newby  2 , Marc R Dweck  2 , Piotr J Slomka  5
Affiliations

Analytical quantification of aortic valve 18F-sodium fluoride PET uptake

Daniele Massera et al. J Nucl Cardiol. 2020 Jun.

Abstract

Background: Challenges to cardiac PET-CT include patient motion, prolonged image acquisition and a reduction of counts due to gating. We compared two analytical tools, FusionQuant and OsiriX, for quantification of gated cardiac 18F-sodium fluoride (18F-fluoride) PET-CT imaging.

Methods: Twenty-seven patients with aortic stenosis were included, 15 of whom underwent repeated imaging 4 weeks apart. Agreement between analytical tools and scan-rescan reproducibility was determined using the Bland-Altman method and Lin's concordance correlation coefficients (CCC).

Results: Image analysis was faster with FusionQuant [median time (IQR) 7:10 (6:40-8:20) minutes] compared with OsiriX [8:30 (8:00-10:10) minutes, p = .002]. Agreement of uptake measurements between programs was excellent, CCC = 0.972 (95% CI 0.949-0.995) for mean tissue-to-background ratio (TBRmean) and 0.981 (95% CI 0.965-0.997) for maximum tissue-to-background ratio (TBRmax). Mean noise decreased from 11.7% in the diastolic gate to 6.7% in motion-corrected images (p = .002); SNR increased from 25.41 to 41.13 (p = .0001). Aortic valve scan-rescan reproducibility for TBRmax was improved with FusionQuant using motion correction compared to OsiriX (error ± 36% vs ± 13%, p < .001) while reproducibility for TBRmean was similar (± 10% vs ± 8% p = .252).

Conclusion: 18F-fluoride PET quantification with FusionQuant and OsiriX is comparable. FusionQuant with motion correction offers advantages with respect to analysis time and reproducibility of TBRmax values.

Keywords: Positron emission tomography; cardiac motion; computed tomography; valvular disease.

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Conflict of interest statement

Conflicts of Interest: none

Figures

Fig. 1
Fig. 1
Panel (a) shows the FusionQuant user interface depicting the aortic valve plane with 18F-fluoride uptake in the aortic valve. Panel (b) shows misaligned PET and CT images in the OsiriX 2D orthogonal reconstruction images user interface including 3D position tool used to correct co-registration errors in a stepwise fashion
Fig. 2
Fig. 2
Aortic valve 18F-fluoride analysis with FusionQuant in a patient with aortic stenosis. Region of interest drawn around anatomically exact borders of aortic valve in the valve plane (axial, coronal and sagittal planes). Panels (a, b and c) show misaligned PET and CT images. Through dragging with the mouse, panels (d, e and f) were achieved. Panels (g, h and i) show reduction in PET image noise and improvement in image quality with motion correction
Fig. 3
Fig. 3
First row: Agreement between OsiriX and FusionQuant: Bland-Altman plots comparing 18F-fluoride uptake measurements in OsiriX vs. FusionQuant, (a) aortic valve TBRmean, (b) aortic valve TBRmax; Second and third row: Bland-Altman plots showing scan-rescan reproducibility for (c) aortic valve TBRmean in OsiriX, (d) aortic valve TBRmean in FusionQuant, (e) aortic valve TBRmax in OsiriX, (f) aortic valve TBRmax in FusionQuant (with motion correction)
See this image and copyright information in PMC

Comment in

  • Multimodality image fusion, moving forward.
    Piccinelli M. Piccinelli M. J Nucl Cardiol. 2020 Jun;27(3):973-975. doi: 10.1007/s12350-019-01607-0. Epub 2019 Jan 28. J Nucl Cardiol. 2020. PMID: 30693427 Free PMC article. No abstract available.

References

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