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Erschienen in: Current Cardiovascular Imaging Reports 11/2017

01.11.2017 | Metabolic Syndrome and Diabetes (V Dilsizian and T Schindler, Section Editors)

Cardiovascular PET/MRI: Technical Considerations and Outlook

verfasst von: S. G. Nekolla, Sandra van Marwick, Sylvia Schachoff, K. P. Kunze, C. Rischpler

Erschienen in: Current Cardiovascular Imaging Reports | Ausgabe 11/2017

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Abstract

Purpose of Review

We aim to provide insights into current and future applications of cardiac PET/MRI and the logistical issues one should consider when implementing a program using this still novel technology.

Recent Findings

Since their introduction around 15 years ago, PET/CT and SPECT/CT hybrid imaging devices saw high clinical utilization, which was driven clearly by oncology. Fortunately, the basic availability in a clinical setting enabled the investigation of the cardiac imaging perspective and facilitated numerous research activities. Given the fact that cardiac MRI is a very attractive research field with an increasing clinical utilization, PET/MRI raised the expectation of innovative imaging scenarios with synergistic applications. Integrating molecular imaging with a multitude of PET agents and the high temporal and spatial resolution of MRI are ideally suited for novel applications having especially a reduced burden of ionizing radiation and potentially a lack of contrast media in mind.

Summary

The technical complexity and consequentially the considerable amount of monetary investment resulted until today in a limited availability and experience. However, the potential of these systems are currently unsurpassed as they really implement a “best of both worlds” approach.
Literatur
1.
Zurück zum Zitat Shaw LJ, Hendel R, Borges-Neto S, Lauer MS, Alazraki N, Burnette J, et al. Prognostic value of normal exercise and adenosine (99m)Tc-tetrofosmin SPECT imaging: results from the multicenter registry of 4,728 patients. J Nucl Med. 2003;44(2):134–9.PubMed Shaw LJ, Hendel R, Borges-Neto S, Lauer MS, Alazraki N, Burnette J, et al. Prognostic value of normal exercise and adenosine (99m)Tc-tetrofosmin SPECT imaging: results from the multicenter registry of 4,728 patients. J Nucl Med. 2003;44(2):134–9.PubMed
12.
Zurück zum Zitat • Nekolla SG, Martinez-Moeller A, Saraste A. PET and MRI in cardiac imaging: from validation studies to integrated applications. Eur J Nucl Med Mol Imaging. 2009;36(Suppl 1):S121–30. https://doi.org/10.1007/s00259-008-0980-1. Although published several years ago—even prior the availability of fully integrated PET/MR systems—most of the items mentioned in this review are still valid today. CrossRefPubMed • Nekolla SG, Martinez-Moeller A, Saraste A. PET and MRI in cardiac imaging: from validation studies to integrated applications. Eur J Nucl Med Mol Imaging. 2009;36(Suppl 1):S121–30. https://​doi.​org/​10.​1007/​s00259-008-0980-1. Although published several years ago—even prior the availability of fully integrated PET/MR systems—most of the items mentioned in this review are still valid today. CrossRefPubMed
19.
Zurück zum Zitat Ibrahim T, Nekolla SG, Langwieser N, Rischpler C, Groha P, Laugwitz KL, et al. Simultaneous positron emission tomography/magnetic resonance imaging identifies sustained regional abnormalities in cardiac metabolism and function in stress-induced transient midventricular ballooning syndrome: a variant of Takotsubo cardiomyopathy. Circulation. 2012;126(21):e324–6. https://doi.org/10.1161/CIRCULATIONAHA.112.134346 CrossRefPubMed Ibrahim T, Nekolla SG, Langwieser N, Rischpler C, Groha P, Laugwitz KL, et al. Simultaneous positron emission tomography/magnetic resonance imaging identifies sustained regional abnormalities in cardiac metabolism and function in stress-induced transient midventricular ballooning syndrome: a variant of Takotsubo cardiomyopathy. Circulation. 2012;126(21):e324–6. https://​doi.​org/​10.​1161/​CIRCULATIONAHA.​112.​134346 CrossRefPubMed
20.
Zurück zum Zitat Langwieser N, Sinnecker D, Rischpler C, Batrice A, van Marwick S, Schwaiger M, et al. Treatment of acute left main occlusion by early revascularization combined with extracorporeal circulation achieves substantial myocardial salvage as assessed by simultaneous positron emission tomography/magnetic resonance imaging. Resuscitation. 2014;85(10):e171–3. https://doi.org/10.1016/j.resuscitation.2014.07.004 CrossRefPubMed Langwieser N, Sinnecker D, Rischpler C, Batrice A, van Marwick S, Schwaiger M, et al. Treatment of acute left main occlusion by early revascularization combined with extracorporeal circulation achieves substantial myocardial salvage as assessed by simultaneous positron emission tomography/magnetic resonance imaging. Resuscitation. 2014;85(10):e171–3. https://​doi.​org/​10.​1016/​j.​resuscitation.​2014.​07.​004 CrossRefPubMed
21.
Zurück zum Zitat Klein C, Nekolla SG, Bengel FM, Momose M, Sammer A, Haas F, et al. Assessment of myocardial viability with contrast-enhanced magnetic resonance imaging: comparison with positron emission tomography. Circulation. 2002;105(2):162–7.CrossRefPubMed Klein C, Nekolla SG, Bengel FM, Momose M, Sammer A, Haas F, et al. Assessment of myocardial viability with contrast-enhanced magnetic resonance imaging: comparison with positron emission tomography. Circulation. 2002;105(2):162–7.CrossRefPubMed
22.
Zurück zum Zitat Rischpler C, Langwieser N, Souvatzoglou M, Batrice A, van Marwick S, Snajberk J, et al. PET/MRI early after myocardial infarction: evaluation of viability with late gadolinium enhancement transmurality vs. 18F-FDG uptake. Eur Heart J Cardiovasc Imaging. 2015;16(6):661–9. https://doi.org/10.1093/ehjci/jeu317 PubMed Rischpler C, Langwieser N, Souvatzoglou M, Batrice A, van Marwick S, Snajberk J, et al. PET/MRI early after myocardial infarction: evaluation of viability with late gadolinium enhancement transmurality vs. 18F-FDG uptake. Eur Heart J Cardiovasc Imaging. 2015;16(6):661–9. https://​doi.​org/​10.​1093/​ehjci/​jeu317 PubMed
23.
24.
Zurück zum Zitat • Dweck MR, Abgral R, Trivieri MG, Robson PM, Karakatsanis N, Mani V, et al. Hybrid magnetic resonance imaging and positron emission tomography with fluorodeoxyglucose to diagnose active cardiac sarcoidosis. JACC Cardiovascular Imaging. 2017; https://doi.org/10.1016/j.jcmg.2017.02.021. The cardiac involvement of sarcoidosis might represent one of the most attractive applications of cardiac PET/MRI. • Dweck MR, Abgral R, Trivieri MG, Robson PM, Karakatsanis N, Mani V, et al. Hybrid magnetic resonance imaging and positron emission tomography with fluorodeoxyglucose to diagnose active cardiac sarcoidosis. JACC Cardiovascular Imaging. 2017; https://​doi.​org/​10.​1016/​j.​jcmg.​2017.​02.​021. The cardiac involvement of sarcoidosis might represent one of the most attractive applications of cardiac PET/MRI.
26.
Zurück zum Zitat Hyafil F, Schindler A, Sepp D, Obenhuber T, Bayer-Karpinska A, Boeckh-Behrens T, et al. High-risk plaque features can be detected in non-stenotic carotid plaques of patients with ischaemic stroke classified as cryptogenic using combined (18)F-FDG PET/MR imaging. Eur J Nucl Med Mol Imaging. 2016;43(2):270–9. https://doi.org/10.1007/s00259-015-3201-8.CrossRefPubMed Hyafil F, Schindler A, Sepp D, Obenhuber T, Bayer-Karpinska A, Boeckh-Behrens T, et al. High-risk plaque features can be detected in non-stenotic carotid plaques of patients with ischaemic stroke classified as cryptogenic using combined (18)F-FDG PET/MR imaging. Eur J Nucl Med Mol Imaging. 2016;43(2):270–9. https://​doi.​org/​10.​1007/​s00259-015-3201-8.CrossRefPubMed
31.
Zurück zum Zitat Pichler B, Lorenz E, Mirzoyan R, Pimpl W, Roder F, Schwaiger M, et al. Performance test of a LSO-APD PET module in a 9.4 Tesla magnet. IEEE Nucl Sci Symp Conf Rec. 1998;1 & 2:1237–9. Pichler B, Lorenz E, Mirzoyan R, Pimpl W, Roder F, Schwaiger M, et al. Performance test of a LSO-APD PET module in a 9.4 Tesla magnet. IEEE Nucl Sci Symp Conf Rec. 1998;1 & 2:1237–9.
34.
Zurück zum Zitat Pichler BJ, Judenhofer MS, Catana C, Walton JH, Kneilling M, Nutt RE, et al. Performance test of an LSO-APD detector in a 7-T MRI scanner for simultaneous PET/MRI. J Nucl Med. 2006;47(4):639–47.PubMed Pichler BJ, Judenhofer MS, Catana C, Walton JH, Kneilling M, Nutt RE, et al. Performance test of an LSO-APD detector in a 7-T MRI scanner for simultaneous PET/MRI. J Nucl Med. 2006;47(4):639–47.PubMed
35.
36.
Zurück zum Zitat Levin C, Deller T, Peterson W, Maramraju SH, Kim C, Prost R. Initial results of simultaneous whole-body ToF PET/MR. J Nucl Med. 2014;55(Supplement 1):660. Levin C, Deller T, Peterson W, Maramraju SH, Kim C, Prost R. Initial results of simultaneous whole-body ToF PET/MR. J Nucl Med. 2014;55(Supplement 1):660.
37.
Zurück zum Zitat Martinez-Moller A, Souvatzoglou M, Navab N, Schwaiger M, Nekolla SG. Artifacts from misaligned CT in cardiac perfusion PET/CT studies: frequency, effects, and potential solutions. J Nucl Med. 2007;48(2):188–93.PubMed Martinez-Moller A, Souvatzoglou M, Navab N, Schwaiger M, Nekolla SG. Artifacts from misaligned CT in cardiac perfusion PET/CT studies: frequency, effects, and potential solutions. J Nucl Med. 2007;48(2):188–93.PubMed
38.
Zurück zum Zitat Gould KL, Pan T, Loghin C, Johnson NP, Guha A, Sdringola S. 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. J Nucl Med. 2007;48(7):1112–21.CrossRefPubMed Gould KL, Pan T, Loghin C, Johnson NP, Guha A, Sdringola S. 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. J Nucl Med. 2007;48(7):1112–21.CrossRefPubMed
42.
Zurück zum Zitat Delso G, Martinez-Moller A, Bundschuh RA, Nekolla SG, Ziegler SI. The effect of limited MR field of view in MR/PET attenuation correction. Med Phys. 2010;37(6):2804–12.CrossRef Delso G, Martinez-Moller A, Bundschuh RA, Nekolla SG, Ziegler SI. The effect of limited MR field of view in MR/PET attenuation correction. Med Phys. 2010;37(6):2804–12.CrossRef
45.
Zurück zum Zitat Wollenweber S, Ambwani S, Lonn AHR, Shanbag DD, Thiruvenkadam S, Kuasshik S, et al. Comparison of 4-class and continuous fat/water methods for whole-body, MR-based PET attenuation correction. IEEE Trans Nucl Sci. 2013;40(5):3391–8.CrossRef Wollenweber S, Ambwani S, Lonn AHR, Shanbag DD, Thiruvenkadam S, Kuasshik S, et al. Comparison of 4-class and continuous fat/water methods for whole-body, MR-based PET attenuation correction. IEEE Trans Nucl Sci. 2013;40(5):3391–8.CrossRef
49.
Zurück zum Zitat Fürst S, Souvatzoglu M, Rischpler C, Ziegler S, Schwaiger M, Nekolla S. Effects of MR contrast agents on attenuation map generation and cardiac PET quantification in PET/MR. J Nucl Med. 2012;53(Supplement 1):139. Fürst S, Souvatzoglu M, Rischpler C, Ziegler S, Schwaiger M, Nekolla S. Effects of MR contrast agents on attenuation map generation and cardiac PET quantification in PET/MR. J Nucl Med. 2012;53(Supplement 1):139.
50.
Zurück zum Zitat Beyer T, Lassen ML, Boellaard R, Delso G, Yaqub M, Sattler B, et al. Investigating the state-of-the-art in whole-body MR-based attenuation correction: an intra-individual, inter-system, inventory study on three clinical PET/MR systems. Magn Reson Mater Phys. 2016;29(1):75–87. https://doi.org/10.1007/s10334-015-0505-4.CrossRef Beyer T, Lassen ML, Boellaard R, Delso G, Yaqub M, Sattler B, et al. Investigating the state-of-the-art in whole-body MR-based attenuation correction: an intra-individual, inter-system, inventory study on three clinical PET/MR systems. Magn Reson Mater Phys. 2016;29(1):75–87. https://​doi.​org/​10.​1007/​s10334-015-0505-4.CrossRef
55.
Zurück zum Zitat • Vontobel J, Liga R, Possner M, Clerc OF, Mikulicic F, Veit-Haibach P, et al. MR-based attenuation correction for cardiac FDG PET on a hybrid PET/MRI scanner: comparison with standard CT attenuation correction. Eur J Nucl Med Mol Imaging. 2015;42(10):1574–80. https://doi.org/10.1007/s00259-015-3089-3. This and the previous reference demonstrate that attenuation correction in PET/MRI in cardiac scans can be successfully implemented for both commercially available systems. CrossRefPubMed • Vontobel J, Liga R, Possner M, Clerc OF, Mikulicic F, Veit-Haibach P, et al. MR-based attenuation correction for cardiac FDG PET on a hybrid PET/MRI scanner: comparison with standard CT attenuation correction. Eur J Nucl Med Mol Imaging. 2015;42(10):1574–80. https://​doi.​org/​10.​1007/​s00259-015-3089-3. This and the previous reference demonstrate that attenuation correction in PET/MRI in cardiac scans can be successfully implemented for both commercially available systems. CrossRefPubMed
56.
Zurück zum Zitat Jea L. Evaluation of attenuation correction in cardiac PET using PET/MR. J Nucl Cardiol. 2016;57(2):215–20. Jea L. Evaluation of attenuation correction in cardiac PET using PET/MR. J Nucl Cardiol. 2016;57(2):215–20.
64.
Zurück zum Zitat DiFilippo FP, Brunken RC. Do implanted pacemaker leads and ICD leads cause metal-related artifact in cardiac PET/CT? J Nucl Med. 2005;46(3):436–43.PubMed DiFilippo FP, Brunken RC. Do implanted pacemaker leads and ICD leads cause metal-related artifact in cardiac PET/CT? J Nucl Med. 2005;46(3):436–43.PubMed
75.
Zurück zum Zitat Munoz C, Neji R, Cruz G, Mallia A, Jeljeli S, Reader AJ, et al. Motion-corrected simultaneous cardiac positron emission tomography and coronary MR angiography with high acquisition efficiency. Magn Reson Med. 2017; https://doi.org/10.1002/mrm.26690. Munoz C, Neji R, Cruz G, Mallia A, Jeljeli S, Reader AJ, et al. Motion-corrected simultaneous cardiac positron emission tomography and coronary MR angiography with high acquisition efficiency. Magn Reson Med. 2017; https://​doi.​org/​10.​1002/​mrm.​26690.
Metadaten
Titel
Cardiovascular PET/MRI: Technical Considerations and Outlook
verfasst von
S. G. Nekolla
Sandra van Marwick
Sylvia Schachoff
K. P. Kunze
C. Rischpler
Publikationsdatum
01.11.2017
Verlag
Springer US
Erschienen in
Current Cardiovascular Imaging Reports / Ausgabe 11/2017
Print ISSN: 1941-9066
Elektronische ISSN: 1941-9074
DOI
https://doi.org/10.1007/s12410-017-9435-z

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