Why the study?
Does dynamic dual-tracer [13N]NH3 and [18F]FDG PET/MRI accurately measure left and right ventricular functional parameters compared to CMR in patients with coronary heart disease?
Does dynamic dual-tracer [13N]NH3 and [18F]FDG PET/MRI accurately measure left and right ventricular functional parameters compared to CMR in patients with coronary heart disease?
Deriving left and right ventricular functional parameters from various phases of dynamic NH3 and FDG PET is feasible and correlates well with CMR, potentially allowing simultaneous assessment of cardiac function during oncological or viability PET scans.
May enable simultaneous ventricular function assessment during PET scans; leaves open validation against outcomes before clinical adoption.
Cardiac positron emission tomography/magnetic resonance imaging (PET/MRI) can assess various cardiovascular diseases. In this study, we intra-individually compared right (RV) and left ventricular (LV) parameters obtained from dual-tracer PET/MRI scan. In 22 patients with coronary heart disease (69 ± 9 years) dynamic [ 13 N]NH 3 (NH 3 ) and [ 18 F]FDG (FDG) PET scans were acquired. The first 2 minutes were used to calculate LV and RV first-pass ejection fraction (FPEF). Additionally, LV end-systolic (LVESV) and end-diastolic (LVEDV) volume and ejection fraction (LVEF) were calculated from the early (EP) and late-myocardial phases (LP). MRI served as a reference. RVFPEF and LVFPEF from FDG and NH 3 as well as RVEF and LVEF from MRI were (28 ± 11%, 32 ± 15%), (32 ± 11%, 41 ± 14%) and (42 ± 16%, 45 ± 19%), respectively. LVESV, LVEDV and LVEF from EP FDG and NH 3 in 8 and 16 gates were [71 (15 to 213 mL), 98 (16 to 241 mL), 32 ± 17%] and [50 (17 to 206 mL), 93 (13 to 219 mL), 36 ± 17%] as well as [60 (19 to 360 mL), 109 (56 to 384 mL), 41 ± 22%] and [54 (16 to 371 mL), 116 (57 to 431 mL), 46 ± 24%], respectively. Moreover, LVESV, LVEDV and LVEF acquired from LP FDG and NH 3 were (85 ± 63 mL, 138 ± 63 mL, 47 ± 19%) and (79 ± 56 mL, 137 ± 63 mL, 47 ± 20%), respectively. The LVESV, LVEDV from MRI were 93 ± 66 mL and 153 ± 71 mL, respectively. Significant correlations were observed for RVFPEF and LVFPEF between FDG and MRI ( R = .51, P = .01; R = .64, P = .001), respectively. LVESV, LVEDV, and LVEF revealed moderate to strong correlations to MRI when they acquired from EP FDG and NH 3 in 16 gates (all R > .7, P = .000). Similarly, all LV parameters from LP FDG and NH 3 correlated good to strongly positive with MRI (all R > .7, and P < .001), except EDV from NH3 weakly correlated to EDV of MRI ( R = .54, P < .05). Generally, Bland-Altman plots showed good agreements between PET and MRI. Deriving LV and RV functional values from various phases of dynamic NH 3 and FDG PET is feasible. These results could open a new perspective for further clinical applications of the PET examinations.
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Rasul et al. (2020) studied this question.
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