Coronary Flow Reserve on Cardiac PET

Purpose

Automate measurement of myocardial blood flow and coronary flow reserve (CFR) on PET 

Tag(s)

 

Panel

 Cardiac

Define-AI ID

 18040005

Originator

 Dave Wymer

Panel Chair

 Carlo De Cecco

Panel Reviewers

 Cardiac Panel

License

 Creative Commons 4.0

Status  Published
                               

Clinical Implementation


Value Proposition

Coronary flow reserve (CFR) using Rb-82 PET predicts major adverse cardiac events (MACE) independent of perfusion summed stress score parameters. Assessment of quantified coronary flow reserve could improve risk stratification in patients evaluated for ischemia.

Narrative(s)

All patients receiving cardiac PET should have their coronary flow measured with calculated CFR, which may then be automatically populated into the radiology report or a report supplement.

Workflow Description

A patient receives rest/stress protocol cardiac PET/CT using pharmacologic stress. Image sets are obtained along with 10-minute list mode acquisition. Automatic reorientation of the images to the American College of Cardiology and American Heart Association standards and automatic extraction of myocardial and cardiac cavity time-activity curves is performed. Flow quantification uses 1-tissue compartment model extraction with decay correction.

Considerations for Dataset Development


Procedures(s): Dynamic acquisition Cardiac PET

View(s): Standard orthogonal Cardiac PET image set

 

Sex at Birth: {Male, Female}

 

Age: [0,90]

 

Body Surface Area: varied

 

Comorbidities: {Congenital heart disease, ventricular septal defects}

 

Interventions: {Congenital heart disease repair, ischemic heart disease repair}

 

Contrast Material: Rubidium-82 chloride

Technical Specifications


Inputs

DICOM Study

Procedure

Dynamic acquisition Cardiac PET

Views

Standard orthogonal cardiac PET image set

Data Type

DICOM

Modality

PET

Body Region

Chest

Anatomic Focus

Heart

Pharmaceutical

Rubidium-82 chloride

 

Primary Outputs

Myocardial Blood Flow

RadElement ID

RDE296

Definition

Measure myocardial blood flow at rest and stress in each coronary artery distribution

Data Type

Numeric

Value Set

 

Units

Cc/gm/min

 

Seventeen Segment Coronary Flow Reserves

RadElement ID

RDE297

Definition

Calculate coronary flow reserves from myocardial blood flow for each of the AHA segments

Data Type

Numeric

Value Set

 

Units

Cc/gm/min

Public Commenting


Use cases are meant to be a primary vehicle for distributing clinical information to the developer community. They pinpoint precise scenarios within radiology workflows where potential automation could add noticeable value and establish standards for interpreting and passing corresponding common data elements. Implementing effective standards requires the perspective from all stakeholders. So to that end, we encourage your feedback on use cases.

To submit comments, please email DSIUseCases@acr.org with the use case title(s) and relevant comments by January 1, 2019. If more convenient, you may also download this use case and comment directly on the PDF. Just attach the PDF copy on the email.