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Clinical Validation of the Accuracy of Absolute Myocardial Blood Flow Quantification with Dual-Source CT Using 15O-Water PET

Takafuji Masafumi 三重大学

2022.07.20

概要

Purpose: To determine the fitting equation that can correct for the underestimation of myocardial blood flow (MBF) measurement by using dynamic CT perfusion (CTP) with dual-source CT (MBFCT), using MBF with oxygen 15–labeled water (15O-water) PET (MBFPET) as a reference, and to determine the accuracy of corrected MBFCT (MBFCT-corrected) compared with MBFPET in a separate set of participants.
Materials and Methods: In this prospective study (reference no. 2466), 34 participants (mean age, 70 years ±8 [standard deviation]; 27 men) known or suspected to have coronary artery disease underwent dynamic stress CTP and stress 15O-water PET between January 2014 and December 2018. The participants were randomly assigned to either a pilot group (n = 17), to determine the fitting equation on the basis of the generalized Renkin-Crone model that can explain the relation between MBFCT and MBFPET, or to a validation group (n = 17), to validate MBFCT-corrected compared with MBFPET. The agreement between MBFCT-corrected and MBFPET was evaluated by intraclass correlation and Bland-Altman analysis.
Results: In the pilot group, MBFCT was lower than MBFPET (1.24 mL/min/g ± 0.28 vs 2.51 mL/min/g ± 0.89 , P<.001) at the segment level. The relationship between MBFCT and MBFCT-corrected was represented as MBFCT = MBFCT-corrected × {1−exp[−(0.11 × MBFCT-corrected + 1.54)/MBFCT-corrected]}. In the validation group, MBFCT-corrected was 2.66 mL/min/g ± 1.93, and MBFPET was 2.68 mL/min/g ± 1.87 at the vessel level. MBFCT-corrected showed an excellent agreement with MBFPET (intraclass correlation coefficient = 0.93 [95% CI: 0.87, 0.96]). The measurement bias of MBFCT-corrected and MBFPET was –0.02 mL/min/g ±0.74.
Conclusion: Underestimation of MBF by CT was successfully corrected with a correction method that was based on contrast kinetics in the myocardium.

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