Key result
An early dynamic 18F-FDG PET scan of 10-15 minutes with irreversible kinetic modeling provided comparable accuracy (bias 3.1%, SD 12.6%) for quantifying myocardial glucose transport to a full one-hour scan with reversible modeling (bias 3.0%, SD 12.0%).
Why the study?
While 18F-FDG PET assesses myocardial glucose metabolism, its ability to image myocardial glucose transport has rarely been exploited clinically, prompting the evaluation of dynamic scan and kinetic modeling protocols.
Does a shortened 10-15 minute dynamic FDG-PET scan with irreversible kinetic modeling provide comparable myocardial glucose transport quantification to a standard 1-hour scan with reversible modeling in patients with coronary artery disease?
Does a shortened 10-15 minute dynamic FDG-PET scan with irreversible kinetic modeling provide comparable myocardial glucose transport quantification to a standard 1-hour scan with reversible modeling in patients with coronary artery disease?
An early dynamic FDG-PET scan of 10-15 minutes with irreversible kinetic modeling can accurately quantify myocardial glucose transport, potentially reducing scan time and improving patient comfort compared to standard one-hour protocols.
May support shorter FDG-PET protocols in CAD; leaves open prospective validation before clinical use.
F-FDG PET has been used in clinics to assess myocardial glucose metabolism. Its ability for imaging myocardial glucose transport, however, has rarely been exploited in clinics. Using the dynamic FDG-PET scans of ten patients with coronary artery disease, we investigate in this paper appropriate dynamic scan and kinetic modeling protocols for efficient quantification of myocardial glucose transport. Three kinetic models and the effect of scan duration were evaluated by using statistical fit quality, assessing the impact on kinetic quantification, and analyzing the practical identifiability. The results show that the kinetic model selection depends on the scan duration. The reversible two-tissue model was needed for a one-hour dynamic scan. The irreversible two-tissue model was optimal for a scan duration of around 10-15 minutes. If the scan duration was shortened to 2-3 minutes, a one-tissue model was the most appropriate. For global quantification of myocardial glucose transport, we demonstrated that an early dynamic scan with a duration of 10-15 minutes and irreversible kinetic modeling was comparable to the full one-hour scan with reversible kinetic modeling. Myocardial glucose transport quantification provides an additional physiological parameter on top of the existing assessment of glucose metabolism and has the potential to enable single tracer multiparametric imaging in the myocardium.
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A 2020 study studied Coronary artery disease (n=10). Early dynamic 18F-FDG PET scan (10-15 minutes) with irreversible kinetic modeling vs. One-hour dynamic scan with reversible kinetic modeling was evaluated on Accuracy of myocardial glucose transport rate (K1) quantification. An early dynamic 18F-FDG PET scan of 10-15 minutes with irreversible kinetic modeling provided comparable accuracy (bias 3.1%, SD 12.6%) for quantifying myocardial glucose transport to a full one-hour scan with reversible modeling (bias 3.0%, SD 12.0%).
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