British Heart Foundation Centre of Cardiovascular Sciences, University of Edinburgh, Room SU.305, Chancellor's building, 51 Little France Crescent, University of Edinburgh, Edinburgh, EH16 4SB, UK.
Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK.
J Nucl Cardiol. 2021 Oct;28(5):1-12. doi: 10.1007/s12350-019-01962-y. Epub 2019 Dec 2.
F-Fluoride uptake denotes calcification activity in aortic stenosis and atherosclerosis. While PET/MR has several advantages over PET/CT, attenuation correction of PET/MR data is challenging, limiting cardiovascular application. We compared PET/MR and PET/CT assessments of F-fluoride uptake in the aortic valve and coronary arteries.
18 patients with aortic stenosis or recent myocardial infarction underwent F-fluoride PET/CT followed immediately by PET/MR. Valve and coronary F-fluoride uptake were evaluated independently. Both standard (Dixon) and novel radial GRE) MR attenuation correction (AC) maps were validated against PET/CT with results expressed as tissue-to-background ratios (TBRs). Visually, aortic valve F-fluoride uptake was similar on PET/CT and PET/MR. TBR values were comparable with radial GRE AC (PET/CT 1.55±0.33 vs. PET/MR 1.58 ± 0.34, P = 0.66; 95% limits of agreement - 27% to + 25%) but performed less well with Dixon AC (1.38 ± 0.44, P = 0.06; bias (-)14%; 95% limits of agreement - 25% to + 53%). In native coronaries, F-fluoride uptake was similar on PET/MR to PET/CT regardless of AC approach. PET/MR identified 28/29 plaques identified on PET/CT; however, stents caused artifact on PET/MR making assessment of F-fluoride uptake challenging.
Cardiovascular PET/MR demonstrates good visual and quantitative agreement with PET/CT. However, PET/MR is hampered by stent-related artifacts currently limiting clinical application.
氟-18 摄取表示主动脉瓣狭窄和动脉粥样硬化的钙化活性。虽然 PET/MR 比 PET/CT 具有多项优势，但 PET/MR 数据的衰减校正具有挑战性，限制了其在心血管方面的应用。我们比较了 PET/MR 和 PET/CT 评估主动脉瓣和冠状动脉氟-18 摄取。
18 例主动脉瓣狭窄或近期心肌梗死患者接受氟-18 PET/CT 检查，随后立即行 PET/MR 检查。独立评估瓣膜和冠状动脉氟-18 摄取。使用 PET/CT 验证标准（Dixon）和新型径向 GRE 衰减校正（AC）图，结果表示为组织与背景比值（TBR）。从视觉上看，主动脉瓣氟-18 摄取在 PET/CT 和 PET/MR 上相似。TBR 值与径向 GRE AC 相当（PET/CT 1.55±0.33 比 PET/MR 1.58±0.34，P=0.66；95%一致性界限 -27%至+25%），但与 Dixon AC 相比性能较差（1.38±0.44，P=0.06；偏差（-）14%；95%一致性界限 -25%至+53%）。在原生冠状动脉中，无论采用何种 AC 方法，氟-18 摄取在 PET/MR 上与 PET/CT 相似。PET/MR 识别出 29 个斑块中的 28 个；然而，支架在 PET/MR 上产生伪影，使得氟-18 摄取的评估具有挑战性。
心血管 PET/MR 与 PET/CT 具有良好的视觉和定量一致性。然而，目前支架相关伪影限制了其临床应用，阻碍了 PET/MR 的发展。
