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MR-PET in Cardiology: An Overview and Selected Cases

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PET/MRI

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Abstract

Since the turn of the millennium, PET/CT devices evolved as the first generation of hybrid imaging systems integrating nuclear and radiological imaging from a valuable research tool into a clinically useful and accepted technique. These innovative devices combined morphological and metabolic-functional information in an elegant way and reached widespread distribution. Therefore, it seemed quite obvious to develop a PET/MR system. However, the technical hurdles for this kind of integration were for physic’s reasons much higher – but were finally solved: for more than 2 years, integrated whole-body systems are now available and, in view of the success of PET/CT, the expectations are high that PET/MR provides an actual clinical benefit. MRI’s advantage of an excellent soft tissue contrast and the capability of functional imaging at the molecular level by PET should have the potential to create a unique multimodality imaging. However, PET/MR in general and in cardiac imaging in particular needs to demonstrate its suitability in everyday clinical practice. In this review we give an overview of the requirements and features of this new hybrid imaging system and provide an outlook based on clinical examples, in which areas PET/MR could potentially find a place in the armamentarium of cardiac imaging.

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References

  1. Von Schulthess GK, Hany TF. Imaging and pet-pet/ct imaging. J Radiol. 2008;89:438–47; quiz 448.

    Article  Google Scholar 

  2. Knuuti J, Saraste A. Combined functional and anatomical imaging for the detection and guiding the therapy of coronary artery disease. Eur Heart J. 2013;34:1954–7.

    Article  PubMed  Google Scholar 

  3. 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.

    Article  PubMed  Google Scholar 

  4. Rischpler C, Nekolla SG, Dregely I, Schwaiger M. Hybrid pet/mr imaging of the heart: potential, initial experiences, and future prospects. J Nucl Med. 2013;54:402–15.

    Article  PubMed  CAS  Google Scholar 

  5. Zaidi H, Ojha N, Morich M, Griesmer J, Hu Z, Maniawski P, Ratib O, Izquierdo-Garcia D, Fayad ZA, Shao L. Design and performance evaluation of a whole-body ingenuity tf pet-mri system. Phys Med Biol. 2011;56:3091–106.

    Article  PubMed  CAS  Google Scholar 

  6. Schlemmer HP, Pichler BJ, Schmand M, Burbar Z, Michel C, Ladebeck R, Jattke K, Townsend D, Nahmias C, Jacob PK, Heiss WD, Claussen CD. Simultaneous mr/pet imaging of the human brain: feasibility study. Radiology. 2008;248:1028–35.

    Article  PubMed  Google Scholar 

  7. 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;48:188–93.

    PubMed  Google Scholar 

  8. 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;48:1112–21.

    Article  PubMed  Google Scholar 

  9. Martinez-Moller A, Souvatzoglou M, Delso G, Bundschuh RA, Chefd’hotel C, Ziegler SI, Navab N, Schwaiger M, Nekolla SG. Tissue classification as a potential approach for attenuation correction in whole-body pet/mri: evaluation with pet/ct data. J Nucl Med. 2009;50:520–6.

    Article  PubMed  Google Scholar 

  10. Coombs BD, Szumowski J, Coshow W. Two-point dixon technique for water-fat signal decomposition with b0 inhomogeneity correction. Magn Reson Med. 1997;38:884–9.

    Article  PubMed  CAS  Google Scholar 

  11. Drzezga A, Souvatzoglou M, Eiber M, Beer AJ, Furst S, Martinez-Moller A, Nekolla SG, Ziegler S, Ganter C, Rummeny EJ, Schwaiger M. First clinical experience with integrated whole-body pet/mr: comparison to pet/ct in patients with oncologic diagnoses. J Nucl Med. 2012;53:845–55.

    Article  PubMed  Google Scholar 

  12. Souvatzoglou M, Eiber M, Takei T, Furst S, Maurer T, Gaertner F, Geinitz H, Drzezga A, Ziegler S, Nekolla SG, Rummeny EJ, Schwaiger M, Beer AJ. Comparison of integrated whole-body [c]choline pet/mr with pet/ct in patients with prostate cancer. Eur J Nucl Med Mol Imaging. 2013;40(10):1486-99.

    Google Scholar 

  13. Schulz V, Torres-Espallardo I, Renisch S, Hu Z, Ojha N, Bornert P, Perkuhn M, Niendorf T, Schafer WM, Brockmann H, Krohn T, Buhl A, Gunther RW, Mottaghy FM, Krombach GA. Automatic, three-segment, mr-based attenuation correction for whole-body pet/mr data. Eur J Nucl Med Mol Imaging. 2011;38:138–52.

    Article  PubMed  CAS  Google Scholar 

  14. 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;37:2804–12.

    Article  PubMed  Google Scholar 

  15. Blumhagen JO, Ladebeck R, Fenchel M, Scheffler K. Mr-based field-of-view extension in mr/pet: B(0) homogenization using gradient enhancement (huge). Magn Reson Med. 2012. doi:10.1002/mrm.24555.

  16. Nuyts J, Bal G, Kehren F, Fenchel M, Michel C, Watson C. Completion of a truncated attenuation image from the attenuated pet emission data. IEEE Trans Med Imaging. 2013;32:237–46.

    Article  PubMed  Google Scholar 

  17. Lau JM, Sharma S, Laforest R, McConathy J, Barnwell J, Priatna A, Becker LM, Foster GJ, Gropler RJ, Woodard PK. Feasibility of mri attenuation correction in cardiac fdg-pet. J Cardiovasc Magn Reson. 2013;15 Suppl 1:O61.

    Google Scholar 

  18. Nensa F, Poeppel TD, Beiderwellen K, Schelhorn J, Mahabadi AA, Erbel R, Heusch P, Nassenstein K, Bockisch A, Forsting M, Schlosser T. Hybrid pet/mr imaging of the heart: feasibility and initial results. Radiology. 2013;268(2):366–73.

    Article  PubMed  Google Scholar 

  19. Knuuti MJ, Nuutila P, Ruotsalainen U, Saraste M, Harkonen R, Ahonen A, Teras M, Haaparanta M, Wegelius U, Haapanen A, et al. Euglycemic hyperinsulinemic clamp and oral glucose load in stimulating myocardial glucose utilization during positron emission tomography. J Nucl Med. 1992;33:1255–62.

    PubMed  CAS  Google Scholar 

  20. Beanlands RSB, Hendry PJ, Masters RG, de Kemp RA, Woodend K, Ruddy TD. Delay in revascularization is associated with increased mortality rate in patients with severe left ventricular dysfunction and viable myocardium on fluorine 18-fuorodeoxyglucose positron emission tomography imaging. Circulation. 1998;98:Ii51–6.

    PubMed  CAS  Google Scholar 

  21. Klein C, Nekolla SG, Balbach T, Schnackenburg B, Nagel E, Fleck E, Schwaiger M. The influence of myocardial blood flow and volume of distribution on late gd-dtpa kinetics in ischemic heart failure. J Magn Reson Imaging. 2004;20:588–93.

    Article  PubMed  Google Scholar 

  22. Klein C, Nekolla SG, Bengel FM, Momose M, Sammer A, Haas F, Schnackenburg B, Delius W, Mudra H, Wolfram D, Schwaiger M. Assessment of myocardial viability with contrast-enhanced magnetic resonance imaging: comparison with positron emission tomography. Circulation. 2002;105:162–7.

    Article  PubMed  Google Scholar 

  23. Klein C, Schmal TR, Nekolla SG, Schnackenburg B, Fleck E, Nagel E. Mechanism of late gadolinium enhancement in patients with acute myocardial infarction. J Cardiovasc Magn Reson. 2007;9:653–8.

    Article  PubMed  Google Scholar 

  24. Kwong RY, Chan AK, Brown KA, Chan CW, Reynolds HG, Tsang S, Davis RB. 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. Circulation. 2006;113:2733–43.

    Article  PubMed  Google Scholar 

  25. Schinkel AFL, Poldermans D, Elhendy A, Bax JJ. Assessment of myocardial viability in patients with heart failure. J Nucl Med. 2007;48:1135–46.

    Article  PubMed  Google Scholar 

  26. Ibrahim T, Hackl T, Nekolla SG, Breuer M, Feldmair M, Schomig A, Schwaiger M. Acute myocardial infarction: serial cardiac mr imaging shows a decrease in delayed enhancement of the myocardium during the 1st week after reperfusion. Radiology. 2010;254:88–97.

    Article  PubMed  Google Scholar 

  27. Wu YW, Tadamura E, Yamamuro M, Kanao S, Marui A, Tanabara K, Komeda M, Togashi K. Comparison of contrast-enhanced mri with (18)f-fdg pet/201tl spect in dysfunctional myocardium: relation to early functional outcome after surgical revascularization in chronic ischemic heart disease. J Nucl Med. 2007;48:1096–103.

    Article  PubMed  Google Scholar 

  28. van der Laan AM, Nahrendorf M, Piek JJ. Healing and adverse remodelling after acute myocardial infarction: Role of the cellular immune response. Heart. 2012;98:1384–90.

    Article  PubMed  Google Scholar 

  29. Lee WW, Marinelli B, van der Laan AM, Sena BF, Gorbatov R, Leuschner F, Dutta P, Iwamoto Y, Ueno T, Begieneman MPV, Niessen HWM, Piek JJ, Vinegoni C, Pittet MJ, Swirski FK, Tawakol A, Di Carli M, Weissleder R, Nahrendorf M. Pet/mri of inflammation in myocardial infarction. J Am Coll Cardiol. 2012;59:153–63.

    Article  PubMed  CAS  Google Scholar 

  30. Williams G, Kolodny GM. Suppression of myocardial 18f-fdg uptake by preparing patients with a high-fat, low-carbohydrate diet. AJR Am J Roentgenol. 2008;190:W151–6.

    Article  PubMed  Google Scholar 

  31. Watanabe E, Kimura F, Nakajima T, Hiroe M, Kasai Y, Nagata M, Kawana M, Hagiwara N. Late gadolinium enhancement in cardiac sarcoidosis: characteristic magnetic resonance findings and relationship with left ventricular function. J Thorac Imaging. 2013;28:60–6.

    Article  PubMed  Google Scholar 

  32. Mc Ardle BA, Leung E, Ohira H, Cocker MS, de Kemp RA, DaSilva J, Birnie D, Beanlands RS, Nery PB. The role of f(18)-fluorodeoxyglucose positron emission tomography in guiding diagnosis and management in patients with known or suspected cardiac sarcoidosis. J Nucl Cardiol. 2013;20:297–306.

    Article  PubMed  CAS  Google Scholar 

  33. Kurisu S, Kihara Y. Tako-tsubo cardiomyopathy: clinical presentation and underlying mechanism. J Cardiol. 2012;60:429–37.

    Article  PubMed  Google Scholar 

  34. Hasbak P, Kjaer A, Skovgaard D, Bang LE, Grande P, Holmvang L. Preserved myocardial blood flow in the apical region involved in takotsubo cardiomyopathy by quantitative cardiac pet assessment. J Nucl Cardiol. 2012;19:169–71.

    Article  PubMed  Google Scholar 

  35. Klocke FJ, Baird MG, Lorell BH, Bateman TM, Messer JV, Berman DS, O’Gara PT, Carabello BA, Russell RO, Cerqueira MD, Sutton MGS, DeMaria AN, Udelson JE, Kennedy JW, Verani MS, Williams KA, Antman EM, Smith SC, Alpert JS, Gregoratos G, Anderson JL, Hiratzka LF, Faxon DP, Hunt SA, Fuster V, Jacobs AK, Gibbons RJ, Russell RO, Heart ACCA. Acc/aha/asnc uidelines 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 radionuclide imaging). J Am Coll Cardiol. 2003;42:1318–33.

    Article  PubMed  Google Scholar 

  36. Parker MW, Iskandar A, Limone B, Perugini A, Kim H, Jones C, Calamari B, Coleman CI, Heller GV. Diagnostic accuracy of cardiac positron emission tomography versus single photon emission computed tomography for coronary artery disease a bivariate meta-analysis. Circ Cardiovasc Imaging. 2012;5:700–7.

    Article  PubMed  Google Scholar 

  37. Yoshinaga K, Chow BJW, Williams K, Chen L, Dekemp RA, Garrard L, Szeto ALT, Aung M, Davies RA, Ruddy TD, Beanlands RSB. What is the prognostic value of myocardial perfusion imaging using rubidium-82 positron emission tomography? J Am Coll Cardiol. 2006;48:1029–39.

    Article  PubMed  Google Scholar 

  38. Merhige ME, Breen WJ, Shelton V, Houston T, D’Arcy BJ, Perna AF. Impact of myocardial perfusion imaging with pet and rb-82 on downstream invasive procedure utilization, costs, and outcomes in coronary disease management. J Nucl Med. 2007;48:1069–76.

    Article  PubMed  Google Scholar 

  39. Manning WJ, Atkinson DJ, Grossman W, Paulin S, Edelman RR. First-pass nuclear magnetic resonance imaging studies using gadolinium-dtpa in patients with coronary artery disease. J Am Coll Cardiol. 1991;18:959–65.

    Article  PubMed  CAS  Google Scholar 

  40. Nandalur KR, Dwamena BA, Choudhri AF, Nandalur MR, Carlos RC. Diagnostic performance of stress cardiac magnetic resonance imaging in the detection of coronary artery disease: a meta-analysis. J Am Coll Cardiol. 2007;50:1343–53.

    Article  PubMed  Google Scholar 

  41. Morton G, Chiribiri A, Ishida M, Hussain ST, Schuster A, Indermuehle A, Perera D, Knuuti J, Baker S, Hedstrom E, Schleyer P, O’Doherty M, Barrington S, Nagel E. Quantification of absolute myocardial perfusion in patients with coronary artery disease: comparison between cardiovascular magnetic resonance and positron emission tomography. J Am Coll Cardiol. 2012;60:1546–55.

    Article  PubMed  Google Scholar 

  42. Bengel FM. Leaving relativity behind: quantitative clinical perfusion imaging. J Am Coll Cardiol. 2011;58:749–51.

    Article  PubMed  Google Scholar 

  43. Schwitter J, Nanz D, Kneifel S, Bertschinger K, Buchi M, Knusel PR, Marincek B, Luscher TF, von Schulthess GK. Assessment of myocardial perfusion in coronary artery disease by magnetic resonance: a comparison with positron emission tomography and coronary angiography. Circulation. 2001;103:2230–5.

    Article  PubMed  CAS  Google Scholar 

  44. O’Neill JO, McCarthy PM, Brunken RC, Buda T, Hoercher K, Young JB, Starling RC. Pet abnormalities in patients with nonischemic cardiomyopathy. J Card Fail. 2004;10:244–9.

    Article  PubMed  Google Scholar 

  45. Terrovitis J, Lautamaki R, Bonios M, Fox J, Engles JM, Yu JH, Leppo MK, Pomper MG, Wahl RL, Seidel J, Tsui BM, Bengel FM, Abraham MR, Marban E. Noninvasive quantification and optimization of acute cell retention by in vivo positron emission tomography after intramyocardial cardiac-derived stem cell delivery. J Am Coll Cardiol. 2009;54:1619–26.

    Article  PubMed  Google Scholar 

  46. Higuchi T, Anton M, Dumler K, Seidl S, Pelisek J, Saraste A, Welling A, Hofmann F, Oostendorp RAJ, Gansbacher B, Nekolla SG, Bengel FM, Botnar RM, Schwaiger M. Combined reporter gene pet and iron oxide mri for monitoring survival and localization of transplanted cells in the rat heart. J Nucl Med. 2009;50:1088–94.

    Article  PubMed  CAS  Google Scholar 

  47. Beer AJ, Schwaiger M. Imaging of integrin alphavbeta3 expression. Cancer Metastasis Rev. 2008;27:631–44.

    Article  PubMed  CAS  Google Scholar 

  48. Higuchi T, Bengel FM, Seidl S, Watzlowik P, Kessler H, Hegenloh R, Reder S, Nekolla SG, Wester HJ, Schwaiger M. Assessment of alpha(v)beta(3) integrin expression after myocardial infarction by positron emission tomography. Cardiovasc Res. 2008;78:395–403.

    Article  PubMed  CAS  Google Scholar 

  49. Makowski MR, Ebersberger U, Nekolla S, Schwaiger M. In vivo molecular imaging of angiogenesis, targeting alpha(v)beta(3) integrin expression, in a patient after acute myocardial infarction. Eur Heart J. 2008;29:2201.

    Article  PubMed  Google Scholar 

  50. Sherif HM, Saraste A, Nekolla SG, Weidl E, Reder S, Tapfer A, Rudelius M, Higuchi T, Botnar RM, Wester HJ, Schwaiger M. Molecular imaging of early alpha(v)beta(3) integrin expression predicts long-term left-ventricle remodeling after myocardial infarction in rats. J Nucl Med. 2012;53:318–23.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Strasse 22, 81675, Munich, Germany

    Stephan G. Nekolla & Christoph Rischpler

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  1. Stephan G. Nekolla
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  2. Christoph Rischpler
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Correspondence to Stephan G. Nekolla .

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Editors and Affiliations

  1. Depto. Medicina Nuclear, Autonomous University of Barcelona Hospital Sant Pau, Barcelona, Spain

    Ignasi Carrio

  2. Department of Radiology, University Hospitals Case Medical Center, Cleveland, Ohio, USA

    Pablo Ros

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Nekolla, S.G., Rischpler, C. (2014). MR-PET in Cardiology: An Overview and Selected Cases. In: Carrio, I., Ros, P. (eds) PET/MRI. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-40692-8_9

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  • DOI: https://doi.org/10.1007/978-3-642-40692-8_9

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