31 Jul PET/MRI : A Feasible Modality for Cardiac Imaging

Hybrid PET/MR Imaging of the Heart: Feasibility and Initial Results
Felix Nensa, MD
Department of Diagnostic and Interventional Radiology and Neuroradiology
University Hospital Essen, University of Duisburg-Essen,
Hufelandstrasse 55, 45147 Essen, Germany;

MedicalResearch.com: What are the main findings of the study?

Dr. Nensa: Cardiac positron emission tomography (PET)/magnetic resonance imaging (MRI) with fluorine 18 fluorodeoxyglucose (FDG) turned out to be feasible with an integrated whole-body 3-Tesla PET/MRI system. Despite the presence of a PET detector in the magnetic field of the MR imaging unit, high-quality cardiac MR images were acquired. PET images originating from a PET/CT and the PET/MR scanner showed very good visual agreement and no statistical significant difference of the mean was found in standardized uptake values, however, variance was considerable. In patients with myocardial infarction, PET and MR images were in good concordance regarding both, cine imaging and late gadolinium-enhanced imaging.

MedicalResearch.com: Were any of the findings unexpected?

Dr. Nensa:

1. Patient compliance was only regarded as moderate, which might result from long examination times associated with fasting. Therefore, consolidated cardiac PET/MRI protocols need to be established.

2. In one patient with an acute occlusion of the left anterior descending artery (LAD) that was treated with percutaneous coronary intervention 3 hours after symptom onset, no late gadolinium-enhancement was found, but PET images showed a clearly reduced tracer uptake in the LAD feeding area that matched myocardial edema in T2-weighted images. Therefore, PET imaging with FDG might help in the assessment of the salvage area at risk.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Nensa:

1. PET/MRI is a feasible modality for cardiac imaging.

2. PET/MRI with FDG can replace sequential FDG PET and MR imaging for the assessment of myocardial viability.

3. PET/MRI with other tracers than FDG might emerge as a valuable tool in cardiac imaging.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Nensa:

1. Integrated software for the combined reading of cardiac PET/MR studies needs to be developed.

2. It needs to be evaluated if cardiac PET/MRI with FDG can help in the assessment of the salvage area at risk.

3. PET/MRI with FDG should be evaluated as a diagnostic tool in other cardiac diseases like myocarditis, sarcoidosis or heart tumor.

4. Cardiac PET/MRI with more specific, non-FDG tracers should be evaluated for various cardiac pathologies like heart failure, myocardial remodeling or inflammation.

Citation:

Radiology. 2013 Aug;268(2):366-73. doi: 10.1148/radiol.13130231. Epub 2013 May 7.

Hybrid PET/MR Imaging of the Heart: Feasibility and Initial Results.

Nensa F, Poeppel TD, Beiderwellen K, Schelhorn J, Mahabadi AA, Erbel R, Heusch P, Nassenstein K, Bockisch A, Forsting M, Schlosser T.

Department of Diagnostic and Interventional Radiology and Neuroradiology, Department of Nuclear Medicine, and Department of Cardiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany.

Last Updated on July 31, 2013 by Marie Benz MD FAAD