Coronary Flow Reserve on Cardiac PET

Purpose	Automate measurement of myocardial blood flow and coronary flow reserve (CFR) on PET
Tag(s)
Panel	Cardiac
TOUCH-AI ID	TAI-04180005
Originator	Dave Wymer
Panel Chair	Carlo De Cecco
Panel Reviewers	Cardiac Panel
License	Creative Commons 4.0
Status	Public Commenting

                               

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.

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

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

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.