Quantitative Positron Emission Tomography for Estimation of Absolute Myocardial Blood Flow

<p>Myocardial perfusion imaging (MPI) with positron emission tomography (PET) is an emerging clinical tool for diagnosis and characterization of ischemic heart disease. The increasing use of PET introduces an opportunity, as it is capable of providing quantitative images that can be analyzed with pharmacokinetic modeling to estimate regional blood flow to the myocardium. Estimating myocardial blood flow (MBF) could provide increased clinical value over MPI alone, particularly if it could be combined with the clinical protocol used in clinical MPI. In this project, we investigated, designed and evaluated methods for MBF estimation that would enable a clinical protocol combining MPI and MBF.</p> <p>We focused on two aspects of the PET data. First, we characterized the adequacy of an existing clinical PET/CT scanner in providing quantitatively-accurate, dynamic ⁸²Rb-PET data over the wide range of radioactivity required for MBF estimation. Activity measurements were biased at early times in the data, so we then developed and validated a method for correcting image bias due to event losses in the detection process. Based on this investigation, we proposed opportunities for improvements to the scanner and later evaluated the performance of a prototype scanner with those improvements. Second, we addressed low counting statistics at late times in the data by quantifying the effect of using the coincidence time-of-flight difference, in particular the precision of its measurement, to reduce image variance. Having generated images with low bias and good precision, we then developed methods to accurately and precisely estimate MBF. We built on existing techniques for compartment modeling by investigating optimal and robust design of the acquisition and reconstruction, and by developing a fast and robust method for calculating flow. Altogether, these investigations have enabled a prospective, human-subjects study to provide data to demonstrate the accuracy of image data, robustness of the flow estimation and practicality of the combined clinical procedure. In future work, we expect that a larger-scale clinical evaluation of the combined MPI and MBF protocol may demonstrate improvements to diagnostic accuracy for coronary artery disease over the use of MPI alone.</p>

Name thesis:degree_name

Doctor of Philosophy

Level thesis:degree_level

doctoral

Discipline thesis:degree_discipline

Biomedical Engineering

Grantor dc:publisher

Case Western Reserve University School of Graduate Studies

Year dc:date

2013

Author dc:creator

• Kolthammer, Jeffrey A.

Contributors dc:contributor

• Muzic, Raymond F.
• Saidel, Gerald M.

• Biomedical Engineering
• Medical Imaging
• Radiology
• positron emission tomography
• PET
• optimal experiment design
• pharmacokinetic modeling
• myocardial blood flow
• myocardial perfusion imaging

Statement dc:rights

• unrestricted
• This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws.

Language dc:language

English

Repository record dc:identifier

http://rave.ohiolink.edu/etdc/view?acc_num=case1365007300

OAI identifier oai:identifier

oai:etd.ohiolink.edu:case1365007300