Detection and prognostication of reversible perfusion abnormalities and scar in patients with suspected coronary ischemia: Results from a pilot study comparing stress cardiac magnetic resonance and positron emission tomography
© Gupta et al; licensee BioMed Central Ltd. 2010
Published: 21 January 2010
Both cardiac positron emission tomography (PET) and cardiac magnetic resonance (CMR) imaging allow assessment of myocardial perfusion and scar in patients with suspected or previously diagnosed ischemic heart disease. There are no clinical studies that have directly compared these two modalities.
In this prospective study, we sought to assess the concordance of CMR and PET in detecting the burden of myocardial ischemia and scar. We also assessed the prognostic association of both modalities with cardiac death or acute myocardial infarction (AMI).
Consecutive patients who underwent stress PET Rubidium perfusion were prospectively enrolled to undergo stress CMR for assessment of ischemia and infarction. Sum rest and sum stress scores were qualitatively graded using a 16-segment model in both PET and CMR. CMR protocol consisted of cine steady-state free precession imaging for left ventricular function, rest and adenosine-stress first pass perfusion at 0.075 mmol/kg, and late gadolinium enhancement (LGE) imaging for myocardial scar.
Detection of reversible perfusion defects on PET and CMR
Patients with no reversible perfusion defect on stress CMR
Patients with reversible perfusion defect on stress CMR
Patients with no reversible perfusion defect on PET
Patients with reversible perfusion defect on PET
Detection of myocardial scar by PET and CMR
Patients with no scar on CMR
Patients with scar on CMR
Patients with no scar on PET
Patients with Scar on PET
In this pilot study we found moderate concordance between CMR and PET. The absence of RevPD and scar on either modality was associated with a good short term prognosis. Patients who had an abnormal CMR but normal PET had an increased incidence of major cardiac events including AMI and death.
This article is published under license to BioMed Central Ltd.