Koppara Tobias, Dregely Isabel, Nekolla Stephan G, Nährig Jörg, Langwieser Nicolas, Bradaric Christian, Ganter Carl, Laugwitz Karl-Ludwig, Schwaiger Markus, Ibrahim Tareq
Department of Internal Medicine I, Cardiology and Angiology, School of Medicine and Health, Technical University of Munich, Munich, Germany.
DZHK (German Center for Cardiovascular Research)-Partner Site Munich Heart Alliance, Munich, Germany.
Front Cardiovasc Med. 2024 Feb 9;11:1352696. doi: 10.3389/fcvm.2024.1352696. eCollection 2024.
Simultaneous positron emission tomography (PET) and magnetic resonance imaging (MRI) is a novel hybrid imaging method integrating the advances of morphological tissue characterization of MRI with the pathophysiological insights of PET applications.
This study evaluated the use of simultaneous 18-FDG PET/MR imaging for characterizing atherosclerotic lesions in lower extremity arterial disease (LEAD).
Eight patients with symptomatic stenoses of the superficial femoral artery (SFA) under simultaneous acquisition of 18-FDG PET and contrast-enhanced MRI using an integrated whole-body PET/MRI scanner. Invasive plaque characterization of the SFA was performed by intravascular imaging using optical coherence tomography. Histological analysis of plaque specimens was performed after directional atherectomy.
MRI showed contrast enhancement at the site of arterial stenosis, as assessed on T2-w and T1-w images, compared to a control area of the contralateral SFA (0.38 ± 0.15 cm vs. 0.23 ± 0.11 cm; 1.77 ± 0.19 vs. 1.57 ± 0.15; -value <0.05). On PET imaging, uptake of 18F-FDG (target-to-background ratio TBR > 1) at the level of symptomatic stenosis was observed in all but one patient. Contrast medium-induced MR signal enhancement was detected in all plaques, whereas FDG uptake in PET imaging was increased in lesions with active fibroatheroma and reduced in fibrocalcified lesions.
In this multimodal imaging study, we report the feasibility and challenges of simultaneous PET/MR imaging of LEAD, which might offer new perspectives for risk estimation.
正电子发射断层扫描（PET）与磁共振成像（MRI）同步检查是一种新型的混合成像方法，它融合了MRI对组织形态特征的研究进展和PET应用中的病理生理学见解。
本研究评估了18-FDG PET/MR同步成像在下肢动脉疾病（LEAD）中对动脉粥样硬化病变的特征描述作用。
使用一体化全身PET/MRI扫描仪，对8例有症状的股浅动脉（SFA）狭窄患者同时进行18-FDG PET和对比增强MRI检查。通过光学相干断层扫描进行血管内成像，对SFA进行有创斑块特征分析。在定向旋切术后对斑块标本进行组织学分析。
与对侧SFA的对照区域相比，MRI显示在T2加权和T1加权图像上动脉狭窄部位有对比增强（0.38±0.15 cm vs. 0.23±0.11 cm；1.77±0.19 vs. 1.57±0.15；P值<0.05）。在PET成像中，除1例患者外，所有患者在有症状狭窄水平均观察到18F-FDG摄取（靶本比TBR>1）。在所有斑块中均检测到对比剂诱导的MR信号增强，而PET成像中FDG摄取在活跃纤维粥样斑块中增加，在纤维钙化病变中减少。
在这项多模态成像研究中，我们报告了LEAD的PET/MR同步成像的可行性和挑战，这可能为风险评估提供新的视角。
