In vitro validation of a simple tomographic technique for estimation of percentage myocardium at risk using methoxyisobutyl isonitrile technetium 99m (sestamibi)

M. K. O'Connor, T. Hammell, Raymond J Gibbons

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Abstract

With the advent of technetium 99m-labeled myocardial blood flow agents, there is a need for a simple technique for quantitation of infarcted or jeopardized myocardium (IM). This study provides an in vitro validation of a simple technique based upon the analysis of three short-axis slices through the heart following emission computed tomography. All acquisitions were performed using a static cardiac phantom containing pertechnetate Tc99m. Activity in the phantom was adjusted so that the count density and myocardial-to-background ratio were comparable to those observed in patients. Plastic insets (range of sizes = 4%-72% of myocardium) were used to simulate transmural infarctions. Eighteen studies were acquired, each over 180° into a 64 x 64 matrix. Data were reconstructed using a Ramp Hanning filter with cut off at 0.7 times the Nyquist frequency. Short-axis slices of the myocardium were then generated, and representative apical (A), mid-ventricular (MV), and basal (B) slices were selected. For each slice, a circumferential profile was generated, and the average radius (R) was measured. The fraction (F) of the profile falling below a threshold value was considered to represent IM. Total IM was given by % IM = 100 x (R(B)F(B) + R(MV)F(MV) + 0.67R(A)F(A))/(R(B) + R(MV) + 0.67R(A)), where the subscripts to R and F refer to the relevant short-axis slices. For a threshold set at 60% of peak, measured IM agreed closely with true IM (R2 = 0.98, measured IM = 1.01 x true IM - 1.35). Measurement of %IM was not distorted by variations in slice radius or in slice selection. Maximum error in %IM occurred with a change in location of the infarct (approximately 4% for opposing walls). This technique permits rapid and accurate assessment of %IM with 99mTc-labeled myocardial blood flow agents.

Original languageEnglish (US)
Pages (from-to)69-76
Number of pages8
JournalEuropean Journal Of Nuclear Medicine
Volume17
Issue number1-2
StatePublished - 1990

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Technetium Tc 99m Sestamibi
Myocardium
Accidental Falls
Emission-Computed Tomography
Sodium Pertechnetate Tc 99m
Architectural Accessibility
Technetium
Infarction
Plastics
In Vitro Techniques

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{ec793549f09544d887f56d7c63b73618,
title = "In vitro validation of a simple tomographic technique for estimation of percentage myocardium at risk using methoxyisobutyl isonitrile technetium 99m (sestamibi)",
abstract = "With the advent of technetium 99m-labeled myocardial blood flow agents, there is a need for a simple technique for quantitation of infarcted or jeopardized myocardium (IM). This study provides an in vitro validation of a simple technique based upon the analysis of three short-axis slices through the heart following emission computed tomography. All acquisitions were performed using a static cardiac phantom containing pertechnetate Tc99m. Activity in the phantom was adjusted so that the count density and myocardial-to-background ratio were comparable to those observed in patients. Plastic insets (range of sizes = 4{\%}-72{\%} of myocardium) were used to simulate transmural infarctions. Eighteen studies were acquired, each over 180° into a 64 x 64 matrix. Data were reconstructed using a Ramp Hanning filter with cut off at 0.7 times the Nyquist frequency. Short-axis slices of the myocardium were then generated, and representative apical (A), mid-ventricular (MV), and basal (B) slices were selected. For each slice, a circumferential profile was generated, and the average radius (R) was measured. The fraction (F) of the profile falling below a threshold value was considered to represent IM. Total IM was given by {\%} IM = 100 x (R(B)F(B) + R(MV)F(MV) + 0.67R(A)F(A))/(R(B) + R(MV) + 0.67R(A)), where the subscripts to R and F refer to the relevant short-axis slices. For a threshold set at 60{\%} of peak, measured IM agreed closely with true IM (R2 = 0.98, measured IM = 1.01 x true IM - 1.35). Measurement of {\%}IM was not distorted by variations in slice radius or in slice selection. Maximum error in {\%}IM occurred with a change in location of the infarct (approximately 4{\%} for opposing walls). This technique permits rapid and accurate assessment of {\%}IM with 99mTc-labeled myocardial blood flow agents.",
author = "O'Connor, {M. K.} and T. Hammell and Gibbons, {Raymond J}",
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AU - Hammell, T.

AU - Gibbons, Raymond J

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N2 - With the advent of technetium 99m-labeled myocardial blood flow agents, there is a need for a simple technique for quantitation of infarcted or jeopardized myocardium (IM). This study provides an in vitro validation of a simple technique based upon the analysis of three short-axis slices through the heart following emission computed tomography. All acquisitions were performed using a static cardiac phantom containing pertechnetate Tc99m. Activity in the phantom was adjusted so that the count density and myocardial-to-background ratio were comparable to those observed in patients. Plastic insets (range of sizes = 4%-72% of myocardium) were used to simulate transmural infarctions. Eighteen studies were acquired, each over 180° into a 64 x 64 matrix. Data were reconstructed using a Ramp Hanning filter with cut off at 0.7 times the Nyquist frequency. Short-axis slices of the myocardium were then generated, and representative apical (A), mid-ventricular (MV), and basal (B) slices were selected. For each slice, a circumferential profile was generated, and the average radius (R) was measured. The fraction (F) of the profile falling below a threshold value was considered to represent IM. Total IM was given by % IM = 100 x (R(B)F(B) + R(MV)F(MV) + 0.67R(A)F(A))/(R(B) + R(MV) + 0.67R(A)), where the subscripts to R and F refer to the relevant short-axis slices. For a threshold set at 60% of peak, measured IM agreed closely with true IM (R2 = 0.98, measured IM = 1.01 x true IM - 1.35). Measurement of %IM was not distorted by variations in slice radius or in slice selection. Maximum error in %IM occurred with a change in location of the infarct (approximately 4% for opposing walls). This technique permits rapid and accurate assessment of %IM with 99mTc-labeled myocardial blood flow agents.

AB - With the advent of technetium 99m-labeled myocardial blood flow agents, there is a need for a simple technique for quantitation of infarcted or jeopardized myocardium (IM). This study provides an in vitro validation of a simple technique based upon the analysis of three short-axis slices through the heart following emission computed tomography. All acquisitions were performed using a static cardiac phantom containing pertechnetate Tc99m. Activity in the phantom was adjusted so that the count density and myocardial-to-background ratio were comparable to those observed in patients. Plastic insets (range of sizes = 4%-72% of myocardium) were used to simulate transmural infarctions. Eighteen studies were acquired, each over 180° into a 64 x 64 matrix. Data were reconstructed using a Ramp Hanning filter with cut off at 0.7 times the Nyquist frequency. Short-axis slices of the myocardium were then generated, and representative apical (A), mid-ventricular (MV), and basal (B) slices were selected. For each slice, a circumferential profile was generated, and the average radius (R) was measured. The fraction (F) of the profile falling below a threshold value was considered to represent IM. Total IM was given by % IM = 100 x (R(B)F(B) + R(MV)F(MV) + 0.67R(A)F(A))/(R(B) + R(MV) + 0.67R(A)), where the subscripts to R and F refer to the relevant short-axis slices. For a threshold set at 60% of peak, measured IM agreed closely with true IM (R2 = 0.98, measured IM = 1.01 x true IM - 1.35). Measurement of %IM was not distorted by variations in slice radius or in slice selection. Maximum error in %IM occurred with a change in location of the infarct (approximately 4% for opposing walls). This technique permits rapid and accurate assessment of %IM with 99mTc-labeled myocardial blood flow agents.

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