Analytical quantification of aortic valve 18F-sodium fluoride PET uptake.
BACKGROUND
Challenges to cardiac PET-CT include patient motion, prolonged image acquisition and a reduction of counts due to gating. We compared two analytical tools, FusionQuant and OsiriX, for quantification of gated cardiac 18F-sodium fluoride (18F-fluoride) PET-CT imaging.


METHODS
Twenty-seven patients with aortic stenosis were included, 15 of whom underwent repeated imaging 4 weeks apart. Agreement between analytical tools and scan-rescan reproducibility was determined using the Bland-Altman method and Lin's concordance correlation coefficients (CCC).


RESULTS
Image analysis was faster with FusionQuant [median time (IQR) 7:10 (6:40-8:20) minutes] compared with OsiriX [8:30 (8:00-10:10) minutes, p = .002]. Agreement of uptake measurements between programs was excellent, CCC = 0.972 (95% CI 0.949-0.995) for mean tissue-to-background ratio (TBRmean) and 0.981 (95% CI 0.965-0.997) for maximum tissue-to-background ratio (TBRmax). Mean noise decreased from 11.7% in the diastolic gate to 6.7% in motion-corrected images (p = .002); SNR increased from 25.41 to 41.13 (p = .0001). Aortic valve scan-rescan reproducibility for TBRmax was improved with FusionQuant using motion correction compared to OsiriX (error ± 36% vs ± 13%, p < .001) while reproducibility for TBRmean was similar (± 10% vs ± 8% p = .252).


CONCLUSION
18F-fluoride PET quantification with FusionQuant and OsiriX is comparable. FusionQuant with motion correction offers advantages with respect to analysis time and reproducibility of TBRmax values.
['Massera|Daniele|D|', 'Doris|Mhairi K|MK|', 'Cadet|Sebastien|S|', 'Kwiecinski|Jacek|J|', 'Pawade|Tania A|TA|', 'Peeters|Frederique E C M|FECM|', 'Dey|Damini|D|', 'Newby|David E|DE|', 'Dweck|Marc R|MR|', 'Slomka|Piotr J|PJ|']
D000368:Aged D000465:Algorithms D001021:Aortic Valve D005260:Female D005462:Fluorine Radioisotopes D006801:Humans D007091:Image Processing, Computer-Assisted D008297:Male D008875:Middle Aged D009038:Motion D015588:Observer Variation D000072078:Positron Emission Tomography Computed Tomography D015203:Reproducibility of Results D059629:Signal-To-Noise Ratio D012969:Sodium Fluoride D012984:Software D014584:User-Computer Interface
Positron emission tomography cardiac motion computed tomography valvular disease