{"title":"由13n -氨正电子发射断层扫描引起的心肌应变:检测缺血相关的壁运动异常。","authors":"Michinobu Nagao, Masateru Kawakubo, Atsushi Yamamoto, Risako Nakao, Yuka Matsuo, Kenji Fukushima, Akiko Sakai, Mitsuru Momose, Shuji Sakai","doi":"10.17996/anc.22-00161","DOIUrl":null,"url":null,"abstract":"<p><p><i>Background</i>: Due to the limitation of spatial resolution, cardiac nuclear medicine images have not been applied to feature-tracking method to automatic extraction of myocardial contours. We have successfully applied the feature-tracking method to high-resolution cine <sup>13</sup>N-ammonia positron emission tomography (PET) images to calculate the regional myocardial strains. Here, we investigate the potential of <sup>13</sup>N-ammonia PET-derived strain to detect ischemia-related wall motion abnormality. <i>Methods</i>: Data of adenosine-stress/rest <sup>13</sup>N-ammonia PET for 95 coronary artery disease patients was retrospectively analyzed. Using an original algorithm dedicated to <sup>13</sup>N-ammonia PET, the longitudinal strain (LS) corresponding to the three main coronary artery territories [right coronary artery (RCA), left anterior descending artery (LAD), and left circumflex coronary artery (LCX)] was calculated from semi-automatic endocardial contours extraction on cine <sup>13</sup>N-ammonia PET images of the left ventricular long-axis. The presence of ischemia in three main territories was determined from rest and stress-perfusion images. <i>Results</i>: In all three coronary territories, LS at stress was significantly smaller at rest in the ischemic region RCA: -19.2±8.0% vs. -22.7±6.1%, LAD: -19.0±6.9% vs. -24.4±6.4%, LCX: -20.5%±7.6% vs. -22.6±6.9%). In contrast, in the non-ischemic region, there was no significant difference between the LS at stress and at rest. Receiver-operating-characteristic analysis revealed that using the optimal cutoff of the LS ratio of stress to rest, ischemia could be diagnosed with area under the curve of 0.82 in the RCA, 0.86 in the LAD, and 0.69 in the LCX. <i>Conclusions</i>: Myocardial strain derived from endocardial feature-tracking of <sup>13</sup>N-ammonia PET cine imaging is reduced in the ischemia induced by adenosine-stress. The LS ratio of stress to rest may detect wall motion abnormality related to ischemia.</p>","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10696145/pdf/","citationCount":"0","resultStr":"{\"title\":\"Myocardial Strain Derived from <sup>13</sup>N-ammonia Positron Emission Tomography: Detection of Ischemia-Related Wall Motion Abnormality.\",\"authors\":\"Michinobu Nagao, Masateru Kawakubo, Atsushi Yamamoto, Risako Nakao, Yuka Matsuo, Kenji Fukushima, Akiko Sakai, Mitsuru Momose, Shuji Sakai\",\"doi\":\"10.17996/anc.22-00161\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><i>Background</i>: Due to the limitation of spatial resolution, cardiac nuclear medicine images have not been applied to feature-tracking method to automatic extraction of myocardial contours. We have successfully applied the feature-tracking method to high-resolution cine <sup>13</sup>N-ammonia positron emission tomography (PET) images to calculate the regional myocardial strains. Here, we investigate the potential of <sup>13</sup>N-ammonia PET-derived strain to detect ischemia-related wall motion abnormality. <i>Methods</i>: Data of adenosine-stress/rest <sup>13</sup>N-ammonia PET for 95 coronary artery disease patients was retrospectively analyzed. Using an original algorithm dedicated to <sup>13</sup>N-ammonia PET, the longitudinal strain (LS) corresponding to the three main coronary artery territories [right coronary artery (RCA), left anterior descending artery (LAD), and left circumflex coronary artery (LCX)] was calculated from semi-automatic endocardial contours extraction on cine <sup>13</sup>N-ammonia PET images of the left ventricular long-axis. The presence of ischemia in three main territories was determined from rest and stress-perfusion images. <i>Results</i>: In all three coronary territories, LS at stress was significantly smaller at rest in the ischemic region RCA: -19.2±8.0% vs. -22.7±6.1%, LAD: -19.0±6.9% vs. -24.4±6.4%, LCX: -20.5%±7.6% vs. -22.6±6.9%). In contrast, in the non-ischemic region, there was no significant difference between the LS at stress and at rest. Receiver-operating-characteristic analysis revealed that using the optimal cutoff of the LS ratio of stress to rest, ischemia could be diagnosed with area under the curve of 0.82 in the RCA, 0.86 in the LAD, and 0.69 in the LCX. <i>Conclusions</i>: Myocardial strain derived from endocardial feature-tracking of <sup>13</sup>N-ammonia PET cine imaging is reduced in the ischemia induced by adenosine-stress. 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引用次数: 0
摘要
背景:由于空间分辨率的限制,心脏核医学图像尚未应用特征跟踪方法自动提取心肌轮廓。我们成功地将特征跟踪方法应用于高分辨率的13n -氨正电子发射断层扫描(PET)图像,以计算区域心肌应变。在这里,我们研究了13n -氨pet衍生菌株检测缺血相关壁运动异常的潜力。方法:回顾性分析95例冠心病患者的腺苷应激/休息13n -氨PET资料。采用独创的13n -氨PET算法,对左心室长轴13n -氨PET图像进行半自动化心内膜轮廓提取,计算出三个主要冠状动脉区域[右冠状动脉(RCA)、左前降支(LAD)和左旋冠状动脉(LCX)]对应的纵向应变(LS)。通过休息和应激灌注图像确定了三个主要区域的缺血。结果:在所有三个冠状动脉区域,应激时的LS在缺血区明显小于休息时的LS (RCA: -19.2±8.0% vs. -22.7±6.1%,LAD: -19.0±6.9% vs. -24.4±6.4%,LCX: -20.5%±7.6% vs. -22.6±6.9%)。相比之下,在非缺血区域,应激和静止状态下的LS无显著差异。受体工作特征分析显示,采用应激与休息LS比的最佳截止值,RCA、LAD和LCX的曲线下面积分别为0.82、0.86和0.69,可诊断为缺血。结论:13n -氨PET显像心内膜特征追踪的心肌应变在腺苷应激引起的缺血中降低。应力与休息的LS比可以检测与缺血相关的壁运动异常。
Myocardial Strain Derived from 13N-ammonia Positron Emission Tomography: Detection of Ischemia-Related Wall Motion Abnormality.
Background: Due to the limitation of spatial resolution, cardiac nuclear medicine images have not been applied to feature-tracking method to automatic extraction of myocardial contours. We have successfully applied the feature-tracking method to high-resolution cine 13N-ammonia positron emission tomography (PET) images to calculate the regional myocardial strains. Here, we investigate the potential of 13N-ammonia PET-derived strain to detect ischemia-related wall motion abnormality. Methods: Data of adenosine-stress/rest 13N-ammonia PET for 95 coronary artery disease patients was retrospectively analyzed. Using an original algorithm dedicated to 13N-ammonia PET, the longitudinal strain (LS) corresponding to the three main coronary artery territories [right coronary artery (RCA), left anterior descending artery (LAD), and left circumflex coronary artery (LCX)] was calculated from semi-automatic endocardial contours extraction on cine 13N-ammonia PET images of the left ventricular long-axis. The presence of ischemia in three main territories was determined from rest and stress-perfusion images. Results: In all three coronary territories, LS at stress was significantly smaller at rest in the ischemic region RCA: -19.2±8.0% vs. -22.7±6.1%, LAD: -19.0±6.9% vs. -24.4±6.4%, LCX: -20.5%±7.6% vs. -22.6±6.9%). In contrast, in the non-ischemic region, there was no significant difference between the LS at stress and at rest. Receiver-operating-characteristic analysis revealed that using the optimal cutoff of the LS ratio of stress to rest, ischemia could be diagnosed with area under the curve of 0.82 in the RCA, 0.86 in the LAD, and 0.69 in the LCX. Conclusions: Myocardial strain derived from endocardial feature-tracking of 13N-ammonia PET cine imaging is reduced in the ischemia induced by adenosine-stress. The LS ratio of stress to rest may detect wall motion abnormality related to ischemia.