- Poster presentation
- Open Access
Preliminary results of synchronous acquired PET/MRI for viability assessment in patients with reduced cardiac function prior revascularization
© Luecke et al; licensee BioMed Central Ltd. 2015
- Published: 3 February 2015
- Late Enhancement
- Viability Assessment
- Glucose Clamp
- Myocardium SPECT
- Inversion Recovery Sequence
In the STICH trial viability assessed by stress-Echo or SPECT did not prove as a independent prognostic factor in patients prior revascularization. The question was raised if CMR and PET would have changed the results of the STICH trial. Simultaneous acquired PET/MRI has become recently available, combining the gold standards for viability assessment.
We wanted to assess the interrater reliability of viability assessment in a hybrid PET/MR system, to assess if it could have additional value for patients prior revascularization. Therefore we examined 9 patients, scheduled for viability assessment by PET as a simultaneous PET/MR examination (mMR Biograph, Siemens, Erlangen, Germany). All patients were examined 50-60'after i.v. application of a mean activity of 319 MBq. The MRI protocol consisted of Cine SSFP sequences in 2 chamber, 4 chamber and short axis orientation (SA). For late enhancement assessment phase sensitive inversion recovery sequences (PSIR) in SA were acquired 10-15 minutes after administration of 0.15 mmol/kg body weight Gadobutrol (Gadovist, Bayer Healthcare, Berlin, Germany). 7 patients got 50g glucose and a individual dose of insulin, depending on blood glucose level. In 2 patients suffering from type 2 diabetes mellitus a standardized glucose clamp was performed. One patient got an additional Tc-99-Tetrofosmin myocardium SPECT at rest. The myocardium was segmented according to the 17-segment-model of the AHA. Viability was assessed in a binary format (PET: normal=0, diminished FDG uptake 1; MR: normal=0, late enhancement present=1) and a 25% stepwise analysis. Cohens Kappa analysis was performed.
Simultaneous viability assessment was feasible and did show a substantial agreement between methods in this small number of patients. Further analysis aims for an increase of the number of evaluated patients and the correlation of multimodal image data with the clinical outcome.
This study was funded by the Heart Center Leipzig.
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