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Optimization and Reproducibility of Aortic Valve 18F-Fluoride Positron Emission Tomography in Patients With Aortic Stenosis

BACKGROUND—: 18F-Fluoride positron emission tomography (PET) and computed tomography (CT) can measure disease activity and progression in aortic stenosis. Our objectives were to optimize the methodology, analysis, and scan–rescan reproducibility of aortic valve 18F-fluoride PET-CT imaging. METHODS A...

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Autores principales: Pawade, Tania A., Cartlidge, Timothy R.G., Jenkins, William S.A., Adamson, Philip D., Robson, Phillip, Lucatelli, Christophe, Van Beek, Edwin J.R., Prendergast, Bernard, Denison, Alan R., Forsyth, Laura, Rudd, James H.F., Fayad, Zahi A., Fletcher, Alison, Tuck, Sharon, Newby, David E., Dweck, Marc R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5068186/
https://www.ncbi.nlm.nih.gov/pubmed/27733431
http://dx.doi.org/10.1161/CIRCIMAGING.116.005131
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author Pawade, Tania A.
Cartlidge, Timothy R.G.
Jenkins, William S.A.
Adamson, Philip D.
Robson, Phillip
Lucatelli, Christophe
Van Beek, Edwin J.R.
Prendergast, Bernard
Denison, Alan R.
Forsyth, Laura
Rudd, James H.F.
Fayad, Zahi A.
Fletcher, Alison
Tuck, Sharon
Newby, David E.
Dweck, Marc R.
author_facet Pawade, Tania A.
Cartlidge, Timothy R.G.
Jenkins, William S.A.
Adamson, Philip D.
Robson, Phillip
Lucatelli, Christophe
Van Beek, Edwin J.R.
Prendergast, Bernard
Denison, Alan R.
Forsyth, Laura
Rudd, James H.F.
Fayad, Zahi A.
Fletcher, Alison
Tuck, Sharon
Newby, David E.
Dweck, Marc R.
author_sort Pawade, Tania A.
collection PubMed
description BACKGROUND—: 18F-Fluoride positron emission tomography (PET) and computed tomography (CT) can measure disease activity and progression in aortic stenosis. Our objectives were to optimize the methodology, analysis, and scan–rescan reproducibility of aortic valve 18F-fluoride PET-CT imaging. METHODS AND RESULTS—: Fifteen patients with aortic stenosis underwent repeated 18F-fluoride PET-CT. We compared nongated PET and noncontrast CT, with a modified approach that incorporated contrast CT and ECG-gated PET. We explored a range of image analysis techniques, including estimation of blood-pool activity at differing vascular sites and a most diseased segment approach. Contrast-enhanced ECG-gated PET-CT permitted localization of 18F-fluoride uptake to individual valve leaflets. Uptake was most commonly observed at sites of maximal mechanical stress: the leaflet tips and the commissures. Scan–rescan reproducibility was markedly improved using enhanced analysis techniques leading to a reduction in percentage error from ±63% to ±10% (tissue to background ratio MDS mean of 1.55, bias −0.05, limits of agreement −0·20 to +0·11). CONCLUSIONS—: Optimized 18F-fluoride PET-CT allows reproducible localization of calcification activity to different regions of the aortic valve leaflet and commonly to areas of increased mechanical stress. This technique holds major promise in improving our understanding of the pathophysiology of aortic stenosis and as a biomarker end point in clinical trials of novel therapies. CLINICAL TRIAL REGISTRATION—: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02132026.
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spelling pubmed-50681862016-10-28 Optimization and Reproducibility of Aortic Valve 18F-Fluoride Positron Emission Tomography in Patients With Aortic Stenosis Pawade, Tania A. Cartlidge, Timothy R.G. Jenkins, William S.A. Adamson, Philip D. Robson, Phillip Lucatelli, Christophe Van Beek, Edwin J.R. Prendergast, Bernard Denison, Alan R. Forsyth, Laura Rudd, James H.F. Fayad, Zahi A. Fletcher, Alison Tuck, Sharon Newby, David E. Dweck, Marc R. Circ Cardiovasc Imaging Original Articles BACKGROUND—: 18F-Fluoride positron emission tomography (PET) and computed tomography (CT) can measure disease activity and progression in aortic stenosis. Our objectives were to optimize the methodology, analysis, and scan–rescan reproducibility of aortic valve 18F-fluoride PET-CT imaging. METHODS AND RESULTS—: Fifteen patients with aortic stenosis underwent repeated 18F-fluoride PET-CT. We compared nongated PET and noncontrast CT, with a modified approach that incorporated contrast CT and ECG-gated PET. We explored a range of image analysis techniques, including estimation of blood-pool activity at differing vascular sites and a most diseased segment approach. Contrast-enhanced ECG-gated PET-CT permitted localization of 18F-fluoride uptake to individual valve leaflets. Uptake was most commonly observed at sites of maximal mechanical stress: the leaflet tips and the commissures. Scan–rescan reproducibility was markedly improved using enhanced analysis techniques leading to a reduction in percentage error from ±63% to ±10% (tissue to background ratio MDS mean of 1.55, bias −0.05, limits of agreement −0·20 to +0·11). CONCLUSIONS—: Optimized 18F-fluoride PET-CT allows reproducible localization of calcification activity to different regions of the aortic valve leaflet and commonly to areas of increased mechanical stress. This technique holds major promise in improving our understanding of the pathophysiology of aortic stenosis and as a biomarker end point in clinical trials of novel therapies. CLINICAL TRIAL REGISTRATION—: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02132026. Lippincott Williams & Wilkins 2016-10 2016-10-18 /pmc/articles/PMC5068186/ /pubmed/27733431 http://dx.doi.org/10.1161/CIRCIMAGING.116.005131 Text en © 2016 The Authors. Circ Cardiovasc Imaging is published on behalf of the American Heart Association, Inc., by Wolters Kluwer. This is an open access article under the terms of the Creative Commons Attribution (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited.
spellingShingle Original Articles
Pawade, Tania A.
Cartlidge, Timothy R.G.
Jenkins, William S.A.
Adamson, Philip D.
Robson, Phillip
Lucatelli, Christophe
Van Beek, Edwin J.R.
Prendergast, Bernard
Denison, Alan R.
Forsyth, Laura
Rudd, James H.F.
Fayad, Zahi A.
Fletcher, Alison
Tuck, Sharon
Newby, David E.
Dweck, Marc R.
Optimization and Reproducibility of Aortic Valve 18F-Fluoride Positron Emission Tomography in Patients With Aortic Stenosis
title Optimization and Reproducibility of Aortic Valve 18F-Fluoride Positron Emission Tomography in Patients With Aortic Stenosis
title_full Optimization and Reproducibility of Aortic Valve 18F-Fluoride Positron Emission Tomography in Patients With Aortic Stenosis
title_fullStr Optimization and Reproducibility of Aortic Valve 18F-Fluoride Positron Emission Tomography in Patients With Aortic Stenosis
title_full_unstemmed Optimization and Reproducibility of Aortic Valve 18F-Fluoride Positron Emission Tomography in Patients With Aortic Stenosis
title_short Optimization and Reproducibility of Aortic Valve 18F-Fluoride Positron Emission Tomography in Patients With Aortic Stenosis
title_sort optimization and reproducibility of aortic valve 18f-fluoride positron emission tomography in patients with aortic stenosis
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5068186/
https://www.ncbi.nlm.nih.gov/pubmed/27733431
http://dx.doi.org/10.1161/CIRCIMAGING.116.005131
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