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New Research Validates Worth of PET/MR Compared to PET/CT in Cardiac Applications

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Researchers at the Society of Nuclear Medicine and Molecular Imaging's 2013 Annual Meeting say that only a few years ago, an implementation positron emission tomography and magnetic resonance (PET/MR) imaging was available on in research-based institutions; yet have now found a place in current medical practice.

This is particularly true for cardiac indications, for which the highly receptive soft tissue contrast of MR and the practical and metabolic imaging of PET are especially precious. New research validates the worth of PET/MR compared to PET/computed tomography (CT) in cardiac applications.
PET/MR imaging methods have progressed over the past several years, primarily in terms of disease identification and the adjustment of blurring (attenuation). PET/CT systems use CT to balance attenuation, and Pnew research validatesET/MR utilizes MR.

Therefore, a portion of the study dedicated itself to pitting the two systems against one another.

"Our research demonstrated that cardiac PET assessment for heart muscle viability using PET/MR yielded comparable results to PET acquired using PET/CT. It showed that MR can be used for PET attenuation correction in the same way that CT can,” said principal author from the Washington University in St. Louis, Mo, Jeffrey M.C. Lau, MD, PhD.

This cracked the door open for technologies in a semblance of various cardiac applications. Researchers used an imaging agent called F-18 fluorodeoxyglucose (F-18 FDG), which imitates glucose as a resource of energy for the heart and other cells that metabolize the agent voluntarily. F-18 FDG-PET scans tell cardiologists about the metabolic activity of cardiac tissues and overall heart muscle function.

The study examined FDG in cardiac cells by PET/MR contrasted with PET/CT, offering similar results. PET/MR forward toward essential clinical applications, including the use of PET/MR for imaging scarring of heart tissue and consequent impediments after cardiac arrest, with some significant advantages for patients.

"Our research provides the groundwork for future research in cardiac PET/MR imaging. PET/MR provides powerful cardiac imaging and requires a lower radiation dose than PET/CT. Also, the MRI component, which can be acquired simultaneously, provides excellent heart muscle signal for imaging scar tissue caused by heart attacks. In particular, our group is most interested in applying the PET/MR technology to evaluate the likelihood of arrhythmia or irregular heart beat development in patients who have had heart attacks,” commented Lau.

The study involved 31 patients with no history of heart complications, all undergoing both PET/CT and PET/MR with F-18 FDG injection given about an hour before PET/CT and two hours before PET/MR. Attenuation was minimized using a specialized dual-echo MR sequence that orders radiofrequency magnetic fields interrelate with atomic nuclei in the body to "see" differentiation between water and fat.

The intake of FDG in the myocardium, or heart muscle wall, was calculated by looking at a cross-section of the left ventricle of the heart that releases oxygen-rich blood into the aorta. The median measurement of FDG intake in the left ventricle was nearly indistinguishable, 4.68 for PET/MR and 4.62 for PET/CT.

Studies have shown that implanted cardiac defibrillators (ICD) are linked to the progression of ventricular arrhythmias in up to a third of implanted patients within three years. Researchers hope to collect more information about this correlation with future PET/MR studies.


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