Test–retest repeatability of myocardial oxidative metabolism and efficiency using standalone dynamic 11C-acetate PET and multimodality approaches in healthy controls

background:myocardial efficiency measured by 11c-acetate positron emission tomography (pet) has successfully been used in clinical research to quantify mechanoenergetic coupling. the objective of this study was to establish the repeatability of myocardial external efficiency (mee) and work metabolic index (wmi) by non-invasive concepts. methods: and results:ten healthy volunteers (63 ± 4 years) were examined twice, one week apart, using 11c-acetate pet, cardiovascular magnetic resonance (cmr), and echocardiography. myocardial oxygen consumption from pet was combined with stroke work data from cmr, echocardiography, or pet to obtain mee and wmi for each modality. repeatability was estimated as the coefficient of variation (cv) between test and retest. meecmr, meeecho, and meepet values were 21.9 ± 2.7%, 16.4 ± 3.7%, and 23.8 ± 4.9%, respectively, p < .001. wmicmr, wmiecho, and wmipet values were 4.42 ± 0.90, 4.07 ± 0.63, and 4.58 ± 1.13 mmhg × ml/m2 × 106, respectively, p = .45. repeatability for meecmr was superior compared with meeecho but did not differ significantly compared with meepet (6.3% vs 12.9% and 9.4%, p = .04 and .25). cv values for wmicmr, wmiecho, and wmipet were 10.0%, 14.8%, and 12.0%, respectively, (p = .53). conclusion:snon-invasive measurements of mee using 11c-acetate pet are highly repeatable. a pet-only approach did not differ significantly from cmr/pet and might facilitate further clinical research due to lower costs and broader applicability.