Myocardial perfusion quantification with Rb-82 PET: good interobserver agreement of Carimas software on global, regional, and segmental levels

Ann Nucl Med. 2022 Jun;36(6):507-514. doi: 10.1007/s12149-022-01729-5. Epub 2022 Feb 22.

Abstract

Purpose: To estimate the interobserver agreement of the Carimas software package (SP) on global, regional, and segmental levels for the most widely used myocardial perfusion PET tracer-Rb-82.

Materials and methods: Rest and stress Rb-82 PET scans of 48 patients with suspected or known coronary artery disease (CAD) were analyzed in four centers using the Carimas SP. We considered values to agree if they simultaneously had an intraclass correlation coefficient (ICC) > 0.75 and a difference < 20% of the median across all observers.

Results: The median values on the segmental level were 1.08 mL/min/g for rest myocardial blood flow (MBF), 2.24 mL/min/g for stress MBF, and 2.17 for myocardial flow reserve (MFR). For the rest MBF and MFR, all the values at all the levels fulfilled were in excellent agreement. For stress MBF, at the global and regional levels, all the 24 comparisons showed excellent agreement. Only 1 out of 102 segmental comparisons (seg. 14) was over the adequate agreement limit-23.5% of the median value (ICC = 0.95).

Conclusion: Interobserver agreement for Rb-82 PET myocardial perfusion quantification analyzed with Carimas is good at any LV segmentation level-global, regional, and segmental. It is good for all the estimates-rest MBF, stress MBF, and MFR.

Keywords: Absolute quantification; Agreement; Carimas; Imaging software; Myocardial blood flow; Myocardial perfusion quantification; PET standardization; Quantitative imaging; Reproducibility; Rubidium-82; Standards in nuclear cardiology.

MeSH terms

  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Circulation / physiology
  • Humans
  • Myocardial Perfusion Imaging*
  • Observer Variation
  • Perfusion
  • Positron-Emission Tomography
  • Reproducibility of Results
  • Rubidium Radioisotopes
  • Software

Substances

  • Rubidium Radioisotopes
  • Rubidium-82