Left ventricular ejection fraction (LVEF) is usually measured by cine-cardiac magnetic resonance imaging (MRI), planar and single-photon emission-computerized tomography (SPECT) equilibrium radionuclide angiocardiography (ERNA), and echocardiography. It would be clinically useful to measure LVEF from first-pass positron-emission tomography/computed tomography (PET/CT) radionuclide angiography, but this approach has been limited by fast radiotracer diffusion. Ultra-sensitive digital PET systems can produce high-quality images within 3-s acquisition times. This study determined whether digital PET/CT accurately measured LVEF in an anthropomorphic heart phantom under conditions mimicking radiotracer first-pass into the cardiac cavities. Heart phantoms in end-diastole and end-systole were 3D-printed from a patient’s MRI dataset. Reference left ventricle end-diastole volume (EDV), end-systole volume (ESV), and LVEF were determined by phantom weights before/after water filling. PET/CT (3-s acquisitions), MRI, and planar and SPECT ERNA were performed. EDV, ESV, and/or LVEF were measured by manual and automated cardiac cavity delineation, using clinical segmentation softwares. LVEF was also measured from PET images converted to 2D “pseudo-planar” images along the short axis and horizontal long axis. LVEF was also calculated for planar ERNA images. All LVEF, ESV and EDV values were compared to the reference values assessed by weighing. Manually calculated 3D-PET-CT-based EDV, ESV, and LVEF were close to MRI and reference values. Automated calculations on the 3D-PET-CT dataset were unreliable, suggesting that the SPECT-based tool used for this calculation is not well adapted for PET acquisitions. Manual and automated LVEF estimations from “pseudo-planar” PET images were very close/identical to MRI and reference values. First-pass “pseudo-planar” PET may be a promising method for estimating LVEF, easy to use in clinical practice. Processing 3D PET images is also a valid method but to date suffers from a lack of well-suited software for automated LV segmentation.

中文翻译：

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从^18张F-FDG首张超敏感数字PET / CT图像测量左心室射血分数的创新程序：使用拟人心脏模型进行评估

左心室射血分数（LVEF）通常通过电影心脏磁共振成像（MRI），平面和单光子发射计算机断层扫描（SPECT）平衡放射性核素血管造影（ERNA）和超声心动图进行测量。从第一遍正电子发射断层扫描/计算机断层扫描（PET / CT）放射性核素血管造影术测量LVEF在临床上将是有用的，但是这种方法受到快速放射性示踪剂扩散的限制。超灵敏的数字PET系统可以在3秒的采集时间内产生高质量的图像。这项研究确定了数字PET / CT在模仿放射性示踪剂首次通过进入心脏腔的条件下，是否能准确地测量拟人化心脏幻影中的LVEF。从患者的MRI数据集中3D打印舒张末期和收缩末期的心脏模型。参考左心室舒张末期容积（EDV），收缩末期容积（ESV）和LVEF由充水之前/之后的幻影重量确定。进行了PET / CT（3 s采集），MRI，平面和SPECT ERNA。EDV，ESV和/或LVEF使用临床分割软件通过手动和自动心腔描画进行测量。LVEF也是从PET图像（沿短轴和水平长轴转换为2D“伪平面”图像）测量的。还针对平面ERNA图像计算了LVEF。将所有LVEF，ESV和EDV值与通过称重评估的参考值进行比较。手动计算的基于3D-PET-CT的EDV，ESV和LVEF接近MRI和参考值。3D-PET-CT数据集的自动计算不可靠，这表明用于该计算的基于SPECT的工具不适用于PET采集。从“伪平面” PET图像进行的手动和自动LVEF估计与MRI和参考值非常接近/相同。首过“伪平面” PET可能是一种很有前景的估计LVEF的方法，易于在临床实践中使用。处理3D PET图像也是一种有效的方法，但迄今为止，缺少适用于自动LV分割的合适软件。