PET and MRI in cardiac imaging: from validation studies to integrated applications

IntroductionPositron emission tomography (PET) is the gold standard for non-invasive assessment of myocardial viability and allows accurate detection of coronary artery disease by assessment of myocardial perfusion. Magnetic resonance imaging (MRI) provides high resolution anatomical images that allow accurate evaluation of ventricular structure and function together with detection of myocardial infarction.ObjectivePotential hybrid PET/MR tomography may potentially facilitate the combination of information from these imaging modalities in cardiology. Furthermore, the combination of anatomical MRI images with the high sensitivity of PET for detecting molecular targets may extent the application of these modalities to the characterization of atherosclerotic plaques and to the evaluation of angiogenetic or stem cell therapies, for example.DiscussionThis article reviews studies using MRI and PET in parallel to compare their performance in cardiac applications together with the potential benefits and applications provided by hybrid PET/MRI systems.

[1]  D. Berman,et al.  Automatic quantification of ejection fraction from gated myocardial perfusion SPECT. , 1995, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[2]  Joseph C. Wu,et al.  Comparison of Imaging Techniques for Tracking Cardiac Stem Cell Therapy , 2007, Journal of Nuclear Medicine.

[3]  Henry Krum,et al.  The Task Force for the diagnosis and treatment of chronic heart failure of the European Society of Cardiology. Guidelines for the diagnosis and treatment of chronic heart failure: full text (update 2005). , 2005, European heart journal.

[4]  Jyrki Lötjönen,et al.  A New Method for the Registration of Cardiac PET and MR Images Using Deformable Model Based Segmentation of the Main Thorax Structures , 2001, MICCAI.

[5]  J. Yap,et al.  Assessment of the reproducibility of baseline and hyperemic myocardial blood flow measurements with 15O-labeled water and PET. , 1999, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[6]  T. R. Schmal,et al.  Mechanism of late gadolinium enhancement in patients with acute myocardial infarction. , 2007, Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance.

[7]  René M. Botnar,et al.  Three-Dimensional Black-Blood Cardiac Magnetic Resonance Coronary Vessel Wall Imaging Detects Positive Arterial Remodeling in Patients With Nonsignificant Coronary Artery Disease , 2002, Circulation.

[8]  L. Shaw,et al.  Myocardial viability testing and impact of revascularization on prognosis in patients with coronary artery disease and left ventricular dysfunction: a meta-analysis. , 2002, Journal of the American College of Cardiology.

[9]  A. van Rossum,et al.  MR-IMPACT: comparison of perfusion-cardiac magnetic resonance with single-photon emission computed tomography for the detection of coronary artery disease in a multicentre, multivendor, randomized trial. , 2008, European heart journal.

[10]  A. Buecker,et al.  Assessment of reversible myocardial dysfunction in chronic ischaemic heart disease: comparison of contrast-enhanced cardiovascular magnetic resonance and a combined positron emission tomography-single photon emission computed tomography imaging protocol. , 2006, European heart journal.

[11]  B. Schnackenburg,et al.  Assessment of Myocardial Viability With Contrast-Enhanced Magnetic Resonance Imaging: Comparison With Positron Emission Tomography , 2002, Circulation.

[12]  Georges El Fakhri,et al.  Quantitative dynamic cardiac 82Rb PET using generalized factor and compartment analyses. , 2005, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[13]  Daniel F. Kacher,et al.  Characterization of Human Atherosclerotic Plaques by Intravascular Magnetic Resonance Imaging , 2005, Circulation.

[14]  Juhani Knuuti,et al.  Assessment of Myocardial Viability with Positron Emission Tomography , 2010 .

[15]  A. Hoes,et al.  Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005): The Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology. , 2005, European heart journal.

[16]  L. Sharples,et al.  Cost-effectiveness of functional cardiac testing in the diagnosis and management of coronary artery disease: a randomised controlled trial. The CECaT trial. , 2007, Health technology assessment.

[17]  E. Voth,et al.  F-18-FDG uptake is a reliable predictory of functional recovery of akinetic but viable infarct regions as defined by magnetic resonance imaging before and after revascularization. , 2004, Magnetic resonance imaging.

[18]  R. Carlos,et al.  Diagnostic performance of stress cardiac magnetic resonance imaging in the detection of coronary artery disease: a meta-analysis. , 2007, Journal of the American College of Cardiology.

[19]  Stephan G Nekolla,et al.  Characterization of normal and infarcted rat myocardium using a combination of small-animal PET and clinical MRI. , 2007, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[20]  Zahi A Fayad,et al.  Imaging atherosclerotic plaque inflammation , 2008, Nature Clinical Practice Cardiovascular Medicine.

[21]  M. Schwaiger,et al.  Assessment of cardiac sympathetic neuronal function using PET imaging , 2004, Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology.

[22]  Tinsu Pan,et al.  Frequent Diagnostic Errors in Cardiac PET/CT Due to Misregistration of CT Attenuation and Emission PET Images: A Definitive Analysis of Causes, Consequences, and Corrections , 2007, Journal of Nuclear Medicine.

[23]  M. Lauer,et al.  Incremental value of rubidium-82 positron emission tomography for prognostic assessment of known or suspected coronary artery disease. , 1997, The American journal of cardiology.

[24]  Stephan G. Nekolla,et al.  Noninvasive Imaging of Transgene Expression by Use of Positron Emission Tomography in a Pig Model of Myocardial Gene Transfer , 2003, Circulation.

[25]  M. Cerqueira,et al.  Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association , 2002, The international journal of cardiovascular imaging.

[26]  Nassir Navab,et al.  Dual cardiac–respiratory gated PET: implementation and results from a feasibility study , 2007, European Journal of Nuclear Medicine and Molecular Imaging.

[27]  Arno Buecker,et al.  Validation of QGS and 4D-MSPECT for quantification of left ventricular volumes and ejection fraction from gated 18F-FDG PET: comparison with cardiac MRI. , 2004, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[28]  John G.F. Cleland,et al.  [Guidelines for the Diagnosis and Treatment of Chronic Heart Failure: executive summary (update 2005)]. , 2005, Revista espanola de cardiologia.

[29]  D A Bluemke,et al.  Relation Between Gd-DTPA Contrast Enhancement and Regional Inotropic Response in the Periphery and Center of Myocardial Infarction , 2001, Circulation.

[30]  Stephan G Nekolla,et al.  Assessment of coronary flow reserve: comparison between contrast-enhanced magnetic resonance imaging and positron emission tomography. , 2002, Journal of the American College of Cardiology.

[31]  Zahi A. Fayad,et al.  Imaging of atherosclerotic cardiovascular disease , 2008, Nature.

[32]  S. Nekolla,et al.  Cardiac oxidative metabolism, function, and metabolic performance in mild hyperthyroidism: a noninvasive study using positron emission tomography and magnetic resonance imaging. , 2003, Thyroid : official journal of the American Thyroid Association.

[33]  Wiro J. Niessen,et al.  Medical Image Computing and Computer-Assisted Intervention – MICCAI 2001 , 2001, Lecture Notes in Computer Science.

[34]  M Schwaiger,et al.  Cardiological applications of nuclear medicine , 1999, The Lancet.

[35]  L. Brewster,et al.  Prognostic value of myocardial 123I-metaiodobenzylguanidine (MIBG) parameters in patients with heart failure: a systematic review. , 2008, European heart journal.

[36]  S. Nekolla,et al.  In vivo molecular imaging of angiogenesis, targeting alphavbeta3 integrin expression, in a patient after acute myocardial infarction. , 2008, European heart journal.

[37]  S. Nekolla,et al.  Attenuation correction in cardiac PET/CT with three different CT protocols: a comparison with conventional PET , 2007, European Journal of Nuclear Medicine and Molecular Imaging.

[38]  Patrick Clarysse,et al.  A review of cardiac image registration methods , 2002, IEEE Transactions on Medical Imaging.

[39]  R. Edelman,et al.  First-pass nuclear magnetic resonance imaging studies using gadolinium-DTPA in patients with coronary artery disease. , 1991, Journal of the American College of Cardiology.

[40]  Karl Swedberg,et al.  Prognostic relevance of atrial fibrillation in patients with chronic heart failure on long-term treatment with beta-blockers: results from COMET. , 2005, European heart journal.

[41]  René M. Botnar,et al.  Coronary magnetic resonance angiography for the detection of coronary stenoses. , 2001, The New England journal of medicine.

[42]  H. Schelbert,et al.  Noninvasive assessment of myocardial perfusion and metabolism: feasibility of registering gated MR and PET images. , 1995, AJR. American journal of roentgenology.

[43]  O. Simonetti,et al.  The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. , 2000, The New England journal of medicine.

[44]  E. Antman,et al.  ACC/AHA/ASNC guidelines for the clinical use of cardiac radionuclide imaging--executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASNC Committee to Revise the 1995 Guidelines for the Clinical Use of Cardiac Radionucl , 2003, Journal of the American College of Cardiology.

[45]  Jeroen J. Bax,et al.  Assessment of Myocardial Viability in Patients with Heart Failure* , 2007, Journal of Nuclear Medicine.

[46]  Keiichiro Yoshinaga,et al.  What is the prognostic value of myocardial perfusion imaging using rubidium-82 positron emission tomography? , 2006, Journal of the American College of Cardiology.

[47]  D J Pennell,et al.  Reduction in sample size for studies of remodeling in heart failure by the use of cardiovascular magnetic resonance. , 2000, Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance.

[48]  A. Buck,et al.  Magnetic resonance-based assessment of global coronary flow and flow reserve and its relation to left ventricular functional parameters: a comparison with positron emission tomography. , 2000, Circulation.

[49]  Nassir Navab,et al.  Artifacts from misaligned CT in cardiac perfusion PET/CT studies: frequency, effects, and potential solutions. , 2007, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[50]  O. Simonetti,et al.  Relationship of MRI delayed contrast enhancement to irreversible injury, infarct age, and contractile function. , 1999, Circulation.

[51]  E. Fleck,et al.  The influence of myocardial blood flow and volume of distribution on late Gd‐DTPA kinetics in ischemic heart failure , 2004, Journal of magnetic resonance imaging : JMRI.

[52]  G. Hutchins,et al.  Interobserver and interstudy variability of myocardial blood flow and flow-reserve measurements with nitrogen 13 ammonia-labeled positron emission tomography , 1995, Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology.

[53]  P. Libby.  Inflammation in atherosclerosis , 2002, Nature.

[54]  Roger B. Davis,et al.  Impact of Unrecognized Myocardial Scar Detected by Cardiac Magnetic Resonance Imaging on Event-Free Survival in Patients Presenting With Signs or Symptoms of Coronary Artery Disease , 2006, Circulation.

[55]  Paul Kinahan,et al.  A combined PET/CT scanner for clinical oncology. , 2000, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[56]  G. Maurer,et al.  Model-based analysis of electrocardiography-gated cardiac (18)F-FDG PET images to assess left ventricular geometry and contractile function. , 2003, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[57]  H. Halperin,et al.  Abnormal sympathetic innervation of viable myocardium and the substrate of ventricular tachycardia after myocardial infarction. , 2008, Journal of the American College of Cardiology.

[58]  Horst Kessler,et al.  Noninvasive Visualization of the Activated αvβ3 Integrin in Cancer Patients by Positron Emission Tomography and [18F]Galacto-RGD , 2005, PLoS medicine.

[59]  E. Boerwinkle,et al.  From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: Part I. , 2003, Circulation.

[60]  M Schwaiger,et al.  Preoperative positron emission tomographic viability assessment and perioperative and postoperative risk in patients with advanced ischemic heart disease. , 1997, Journal of the American College of Cardiology.

[61]  S. Nekolla,et al.  Assessment of alphavbeta3 integrin expression after myocardial infarction by positron emission tomography. , 2008, Cardiovascular research.