Value of a hybrid PET/MRI in the assessment of cardiac viability
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POSTER PRESENTATION
Open Access
Value of a hybrid PET/MRI in the assessment of cardiac viability David Carballo1*, René Nkoulou1, Gabriella Vincenti1, Alessandra Quercioli1, Susanne Heinzer1, Dominique Didier1, Matthias Stuber2, Thomas Schindler1, Osman Ratib1, Jean Vallee1 From 15th Annual SCMR Scientific Sessions Orlando, FL, USA. 2-5 February 2012 Summary Hybrid PET/MRI imaging techniques are become more readily available, and its role in viability assessment appears promising. Background We evaluated the potential for hybrid PET/MRI devices to provide integrated metabolic, functional and anatomic characterization of patients with fixed hypoperfusion on cardiac SPECT. Methods A pilot study of eleven patients (6 fixed hypoperfusion on cardiac SPECT and 5 healthy volunteers) performed an imaging study using a hybrid PET/MRI (Philips). Viability assessed by 18F-FDG was performed in diseased patients along with MRI anatomic, functional and viability assessment as determined by transmural extent of late gadolinium enhancement (LGE). A reassessment by conventional PET/CT was carried out within 30 minutes. Non-contrast right coronary artery (RCA) targeted and whole heart 3D coronary angio-MRI using ECGgating and respiratory navigator was performed in healthy volunteers with reconstruction performed using MPR and volume rendering. The extent of metabolic defect (MD) using PET/MRI and PET/CT were compared in patients and coronary territories (LAD, CX, RCA). Assessibility of coronary lumen was judged as good, sub-optimal or non-assessable using a 16-segments coronary model.
1 Geneva University Hospital, Geneva, Switzerland Full list of author information is available at the end of the article
Results Direct comparison of myocardial viability as assessed by MRI LGE and Pet metabolism revealed consistent results in 4 of the 6 diseased patients, and discordant results in the other two. Of note, one discordant result was potentially due to suboptimal attenuation correction in the case of a hypertrophied left ventricle. Metabolic assessment was successful in all patients with MD being 19.2% vs 18.3% using PET/MRI and PET/CT, respectively (P= ns). The MD was 10.2%, 6%, and 3% vs 9.3%, 6% and 3% for LAD, CX and RCA territories, respectively (P= ns). Coronary angio-MRI was successful in all volunteers with 66 coronary segments visualized overall. The RCA was fully visualized in 4/5 volunteers and the left coronary arteries in 4/5 volunteers. Assessibility in
Figure 1
© 2012 Carballo et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Carballo et al. Journal of Cardiovascular Magnetic Resonance 2012, 14(Suppl 1):P80 http://www.jcmr-online.com/content/14/S1/P80
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Figure 2
visualized segments was good, sub-optimal and non assessable in 88%, 2% and 10%, respect
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