Hybrid PET/MR imaging of the heart: feasibility and initial results

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

Abstract

Purpose: To assess the feasibility of hybrid imaging of the heart with fluorine 18 fluorodeoxyglucose (FDG) on an integrated 3-T positron emission tomography (PET)/magnetic resonance (MR) imaging system.

Materials and methods: The present study was approved by the local institutional review board. Written informed consent was obtained from all patients before imaging. Twenty consecutive patients with myocardial infarction (n = 20) underwent cardiac PET/MR imaging examination. Ten patients underwent additional cardiac PET/computed tomography (CT) before PET/MR. Two-dimensional half-Fourier acquisition single-shot turbo spin-echo sequences, balanced steady-state free precession cine sequences, two-dimensional turbo inversion-recovery magnitude T2-weighted sequences, and late gadolinium-enhanced (LGE) segmented two-dimensional inversion-recovery turbo fast low-angle shot sequences were performed. According to the 17-segment model, PET tracer uptake, wall motion, and late gadolinium enhancement were visually assessed for each segment on a binary scale, and categorical intermethod agreement was calculated by using the Cohen κ. The maximum standardized uptake value was measured in corresponding myocardial locations on PET/CT and PET/MR images.

Results: Agreement was substantial over all patients and segments between PET and LGE images (κ = 0.76) and between PET and cine images (κ = 0.78). In 306 segments, 97 (32%) were rated as infarcted on PET images, compared with 93 (30%) rated as infarcted on LGE images and with 90 (29%) rated as infarcted on cine images. In a subgroup of patients (n = 10) with an additional PET/CT scan, no significant difference in myocardial tracer uptake between PET/CT and PET/MR images was found (paired t test, P = .95).

Conclusion: Cardiac PET/MR imaging with FDG is feasible and may add complementary information in patients with ischemic heart disease.

MeSH terms

  • Cardiac-Gated Imaging Techniques
  • Contrast Media
  • Feasibility Studies
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Magnetic Resonance Imaging, Cine / methods*
  • Male
  • Middle Aged
  • Multimodal Imaging
  • Myocardial Infarction / diagnostic imaging
  • Myocardial Infarction / pathology*
  • Organometallic Compounds
  • Positron-Emission Tomography / methods*
  • Radiopharmaceuticals
  • Tomography, X-Ray Computed

Substances

  • Contrast Media
  • Organometallic Compounds
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • gadobutrol