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

doi:10.1007/s12350-019-01962-y

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 journal › Article › peer-review

14 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. TBR_MAX 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 language	English
Journal	Journal of Nuclear Cardiology
Volume	28
Issue number	5
DOIs	https://doi.org/10.1007/s12350-019-01962-y
State	Published - Oct 2021

Keywords

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

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10.1007/s12350-019-01962-y

Cite this

Andrews, J. P. M., MacNaught, G., Moss, A. J., Doris, M. K., Pawade, T., Adamson, P. D., van Beek, E. J. R., Lucatelli, C., Lassen, M. L., Robson, P. M., Fayad, Z. A., Kwiecinski, J., Slomka, P. J., Berman, D. S., Newby, D. E., & Dweck, M. R. (2021). Cardiovascular ¹⁸F-fluoride positron emission tomography-magnetic resonance imaging: A comparison study. Journal of Nuclear Cardiology, 28(5). https://doi.org/10.1007/s12350-019-01962-y

@article{dc24c89de7fb47ac9342686e67f9d06a,

title = "Cardiovascular 18F-fluoride positron emission tomography-magnetic resonance imaging: A comparison study",

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.",

keywords = "CMR, PET, PET/CT, PET/MR, aortic stenosis, atherothrombosis, myocardial infarction",

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

note = "Publisher Copyright: {\textcopyright} 2019, The Author(s).",

year = "2021",

month = oct,

doi = "10.1007/s12350-019-01962-y",

language = "English",

volume = "28",

journal = "Journal of Nuclear Cardiology",

issn = "1071-3581",

publisher = "American Society of Nuclear Cardiology",

number = "5",

}

Andrews, JPM, MacNaught, G, Moss, AJ, Doris, MK, Pawade, T, Adamson, PD, van Beek, EJR, Lucatelli, C, Lassen, ML, Robson, PM , Fayad, ZA, Kwiecinski, J, Slomka, PJ, Berman, DS, Newby, DE & Dweck, MR 2021, 'Cardiovascular ¹⁸F-fluoride positron emission tomography-magnetic resonance imaging: A comparison study', Journal of Nuclear Cardiology, vol. 28, no. 5. https://doi.org/10.1007/s12350-019-01962-y

TY - JOUR

T1 - Cardiovascular 18F-fluoride positron emission tomography-magnetic resonance imaging

T2 - A comparison study

AU - Andrews, Jack P.M.

AU - MacNaught, Gillian

AU - Moss, Alastair J.

AU - Doris, Mhairi K.

AU - Pawade, Tania

AU - Adamson, Philip D.

AU - van Beek, Edwin J.R.

AU - Lucatelli, Christophe

AU - Lassen, Martin L.

AU - Robson, Philip M.

AU - Fayad, Zahi A.

AU - Kwiecinski, Jacek

AU - Slomka, Piotr J.

AU - Berman, Daniel S.

AU - Newby, David E.

AU - Dweck, Marc R.

PY - 2021/10

Y1 - 2021/10

N2 - 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.

AB - 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.

KW - CMR

KW - PET

KW - PET/CT

KW - PET/MR

KW - aortic stenosis

KW - atherothrombosis

KW - myocardial infarction

UR - http://www.scopus.com/inward/record.url?scp=85075931041&partnerID=8YFLogxK

U2 - 10.1007/s12350-019-01962-y

DO - 10.1007/s12350-019-01962-y

M3 - Article

C2 - 31792913

AN - SCOPUS:85075931041

SN - 1071-3581

VL - 28

JO - Journal of Nuclear Cardiology

JF - Journal of Nuclear Cardiology

IS - 5