Cardiovascular 18F-fluoride positron emission tomography-magnetic resonance imaging: A comparison study

Jack P.M. Andrews, Gillian MacNaught, Alastair J. Moss, Mhairi K. Doris, Tania Pawade, Philip D. Adamson, Edwin J.R. van Beek, Christophe Lucatelli, Martin L. Lassen, Philip M. Robson, Zahi A. Fayad, Jacek Kwiecinski, Piotr J. Slomka, Daniel S. Berman, David E. Newby, Marc R. Dweck

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Background: 18F-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 18F-fluoride uptake in the aortic valve and coronary arteries. Methods and results: 18 patients with aortic stenosis or recent myocardial infarction underwent 18F-fluoride PET/CT followed immediately by PET/MR. Valve and coronary 18F-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 18F-fluoride uptake was similar on PET/CT and PET/MR. TBRMAX 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, 18F-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 18F-fluoride uptake challenging. Conclusion: 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.

Original languageEnglish
JournalJournal of Nuclear Cardiology
Volume28
Issue number5
DOIs
StatePublished - Oct 2021

Keywords

  • CMR
  • PET
  • PET/CT
  • PET/MR
  • aortic stenosis
  • atherothrombosis
  • myocardial infarction

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