Quantifying Brain [18F]FDG Uptake Noninvasively by Combining Medical Health Records and Dynamic PET Imaging Data

IEEE J Biomed Health Inform. 2019 Nov;23(6):2576-2582. doi: 10.1109/JBHI.2018.2890459. Epub 2019 Jan 1.

Abstract

Full quantification of regional cerebral metabolic rate of glucose (rCMRglu) with [18F]fluorodeoxy-glucose ([18F]FDG) positron emission tomography (PET) imaging requires measurement of an arterial input function (AIF) curve, which is obtained with an invasive arterial blood sampling procedure during the scan. We previously proposed a non-invasive simultaneous estimation (nSIME) method that quantifies binding of a PET radioligand by combining individual electronic health records information and a pharmacokinetic AIF (PK-AIF) model. Initially applied only to [11C]DASB data, in this study we validate nSIME for a different radioligand, [18F]FDG, adapting the algorithm to the specific distribution and metabolism of this radioligand. We evaluate the impact of the PK-AIF model, the number of [18F]FDG-specific soft constraints, and the type of predictive strategy. The accuracy of nSIME is then compared to a population-based approach. All analyses are conducted on 67 [18F]FDG PET scans with arterial blood data available for comparison. nSIME performance is optimal for [18F]FDG when using the PK-AIF model, two soft constraints, and an aggregate model to predict the soft constraint values. Higher correlation and lower Bland-Altman spread against gold standard rCMRglu values based on arterial blood measurements are observed for nSIME (r = 0.83, spread = 1.55) compared to the population-based approach (r = 0.77, spread = 2.12). nSIME provides a data-driven estimation of both amplitude and shape of the AIF curve at the individual level and potentially enables non-invasive quantification of PET data across radioligands, avoiding the need for arterial blood sampling.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Brain* / blood supply
  • Brain* / diagnostic imaging
  • Brain* / metabolism
  • Electronic Health Records*
  • Female
  • Fluorodeoxyglucose F18* / blood
  • Fluorodeoxyglucose F18* / metabolism
  • Fluorodeoxyglucose F18* / pharmacokinetics
  • Humans
  • Male
  • Medical Informatics
  • Middle Aged
  • Positron-Emission Tomography / methods*

Substances

  • Fluorodeoxyglucose F18