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Open Access 01-08-2016 | Review

Incremental value of PET and MRI in the evaluation of cardiovascular abnormalities

Authors: Hamid Chalian, James K. O’Donnell, Michael Bolen, Prabhakar Rajiah

Published in: Insights into Imaging | Issue 4/2016

Abstract

The cardiovascular system is affected by a wide range of pathological processes, including neoplastic, inflammatory, ischemic, and congenital aetiology. Magnetic resonance imaging (MRI) and positron emission tomography (PET) are state-of-the-art imaging modalities used in the evaluation of these cardiovascular disorders. MRI has good spatial and temporal resolutions, tissue characterization and multi-planar imaging/reconstruction capabilities, which makes it useful in the evaluation of cardiac morphology, ventricular and valvar function, disease characterization, and evaluation of myocardial viability. FDG-PET provides valuable information on the metabolic activity of the cardiovascular diseases, including ischemia, inflammation, and neoplasm. MRI and FDG-PET can provide complementary information on the evaluation of several cardiovascular disorders. For example, in cardiac masses, FDG-PET provides the metabolic information for indeterminate cardiac masses. MRI can be used for localizing and characterizing abnormal hypermetabolic foci identified incidentally on PET scan and also for local staging. A recent advance in imaging technology has been the development of integrated PET/MRI systems that utilize the advantages of PET and MRI in a single examination. The goal of this manuscript is to provide a comprehensive review on the incremental value of PET and MRI in the evaluation of cardiovascular diseases.

Main Messages

• MRI has good spatial and temporal resolutions, tissue characterization, and multi-planar reconstruction

• FDG-PET provides valuable information on the metabolic activity of cardiovascular disorders

• PET and MRI provide complementary information on the evaluation of cardiovascular disorders

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Nichols M, Townsend N, Scarborough P et al (2015) Cardiovascular disease in Europe 2014: epidemiological update. European Heart Journal 36(40):2673–4PubMed

Douglas PS, Garcia MJ, Haines DE et al (2011) Appropriate use criteria for echocardiography. A report of the american college of cardiology foundation appropriate use criteria task force, ASE, AHA, ASNC, HFSA, HRS, SCAI, SCCM. SCCT J Am Coll Cardiol 57(9):1126–66PubMedCrossRef

Hundley WG, Bluemke DA, Finn JP et al (2010) ACCF/ACR/AHA/NASCI/SCMR 2010 expert consensus document on cardiovascular magnetic resonance: a report of the American college of cardiology foundation task force on expert consensus documents. J Am Coll Cardiol 55(23):2614–62PubMedCrossRef

Skali H, Schulman AR, Dorbala S (2013) (18)F-FDG PET/CT for the assessment of myocardial sarcoidosis. Curr Cardiol Rep 15(5):352PubMedCentralCrossRef

Delbeke D, Coleman RE, Guiberteau MJ et al (2006) Procedure guideline for tumor imaging with 18F-FDG PET/CT 1.0. J Nucl Med 47(5):885–95PubMed

Dorbala S, Di Carli MF, Delbeke D et al (2013) SNMMI/ASNC/SCCT guideline for cardiac SPECT/CT and PET/CT 1.0. J Nucl Med 54(8):1485–507PubMedCrossRef

Cardiac F-18 FDG PET. December 10, 2014]; Available from: http://www.asnc.org/media/PDFs/PPPETFDG081511.pdf.

Surasi DS, Bhambhvani P, Baldwin JA et al (2014) 18F-FDG PET and PET/CT patient preparation: a review of the literature. J Nucl Med Technol 42(1):5–13PubMedCrossRef

Nekolla SG, Martinez-Moeller A, Saraste S (2009) PET and MRI in cardiac imaging: from validation studies to integrated applications. Eur J Nucl Med Mol Imaging 36(Suppl 1):S121–30PubMedCrossRef

10.

Sinha S, Sinha U, Czernin J et al (1995) Noninvasive assessment of myocardial perfusion and metabolism: feasibility of registering gated MR and PET images. AJR Am J Roentgenol 164(2):301–7PubMedCrossRef

11.

Partovi S, Kohan A, Rubbert C et al (2014) Clinical oncologic applications of PET/MRI: a new horizon. Am J Nucl Med Mol Imaging 4(2):202–12PubMedPubMedCentral

12.

Hofmann M, Pichler B, Scholkopf B et al (2009) Towards quantitative PET/MRI: a review of MR-based attenuation correction techniques. Eur J Nucl Med Mol Imaging 36(Suppl 1):S93–104PubMedCrossRef

13.

Yusuf SW, Reardon MJ, Banchs J (2014) Cardiac tumors. Cardiology 129(3):197–8PubMed

14.

Anvari MS, Naderan M, Eslami Shahr Babaki A et al (2014) Clinicopathologic review of non-myxoma cardiac tumors: a 10-year single-center experience. Cardiology 129(3):199–202PubMed

15.

Hoffmann U, Globits S, Schima W et al (2003) Usefulness of magnetic resonance imaging of cardiac and paracardiac masses. Am J Cardiol 92(7):890–5PubMedCrossRef

16.

Rahbar K, Seifarth H, Schafers M et al (2012) Differentiation of malignant and benign cardiac tumors using 18F-FDG PET/CT. J Nucl Med 53(6):856–63PubMedCrossRef

17.

Agostinhi D, Babatasi G, Galateau F et al (1999) Detection of cardiac myxoma by F-18 FDG PET. Clin Nucl Med 24(3):159–60CrossRef

18.

Probst S, Seltzer A, Spieler B et al (2011) The appearance of cardiac metastasis from squamous cell carcinoma of the lung on F-18 FDG PET/CT and post hoc PET/MRI. Clin Nucl Med 36(4):311–2PubMedCrossRef

19.

Wilhem T, Stieltjes B, Schlemmer HP (2013) Whole-body- MR diffusion weighted imaging in oncology. Rofo 185(10):950–8

20.

Tokmak H, Demir N, Demirkol MO (2014) Cardiac angiosarcoma: utility of [(18)F]fluorodeoxyglucose positron emission tomography-computed tomography in evaluation of residue, metastases, and treatment response. Vasc Health Risk Manag 10:399–401PubMedPubMedCentralCrossRef

21.

Nensa F, Tezgah E, Poeppel TD et al (2015) Integrated 18F-FDG PET/MR imaging in the assessment of cardiac masses: a pilot study. J Nucl Med 56(2):255–60PubMedCrossRef

22.

Liu PP, Mason JW (2001) Advances in the understanding of myocarditis. Circulation 104(9):1076–1082PubMedCrossRef

23.

Miyagawa M, Yokoyama R, Nishiyama Y et al (2014) Positron emission tomography-computed tomography for imaging of inflammatory cardiovascular diseases. Circulation Journal 78(6):1302–1310PubMedCrossRef

24.

Friedrich MG, Sechtem U, Schulz-Menger J et al (2009) Cardiovascular magnetic resonance in myocarditis: A JACC White Paper. J Am Coll Cardiol 53(17):1475–87PubMedPubMedCentralCrossRef

25.

Mayroeni S (2012) Myocarditis in systemic diseases and the role of MRI. Hellenic J Cardiol 53(2):142–7

26.

Erba PA, Sollini M, Lazzeri E et al (2013) FDG-PET in cardiac infections. Semin Nucl Med 43(5):377–95PubMedCrossRef

27.

Nensa F, Schlosser T (2014) Cardiovascular hybrid imaging using PET/MRI. Rofo 186(12):1094–101PubMedCrossRef

28.

Rossman MD, Kreider ME (2007) Lesson learned from ACCESS (a case controlled etiologic study of sarcoidosis). Proc Am Thorac Soc 4(5):453–6PubMedCrossRef

29.

Youssef G, Leung E, Mylonas I et al (2012) The use of 18F-FDG PET in the diagnosis of cardiac sarcoidosis: a systematic review and metaanalysis including the Ontario experience. J Nucl Med 53(2):241–8PubMedCrossRef

30.

Amano Y, Tachi M, Tani H, et al. (2012) T2-weighted cardiac magnetic resonance imaging of edema in myocardial diseases. Sci World J. 194069.

31.

Tadamura E, Yamamuro M, Kubo S et al (2005) Effectiveness of delayed enhanced MRI for identification of cardiac sarcoidosis: comparison with radionuclide imaging. AJR Am J Roentgenol 185(1):110–5PubMedCrossRef

32.

Vignaux O (2005) Cardiac sarcoidosis: spectrum of MRI features. AJR Am J Roentgenol 184(1):249–54PubMedCrossRef

33.

Schneider S, Batrice A, Rischpler C et al (2014) Utility of multimodal cardiac imaging with PET/MRI in cardiac sarcoidosis: implications for diagnosis, monitoring and treatment. Eur Heart J 35(5):312PubMedCrossRef

34.

Gentry J, Klein AL, Jellis CL (2016) Transient constrictive pericarditis: current diagnostic and therapeutic strategies. Current Cardiology Reports 18(5):41PubMedCrossRef

35.

Dong A, Dong H, Wang Y et al (2013) 18F-FDG PET/CT in differentiating acute tuberculous from idiopathic pericarditis: preliminary study. Clin Nucl Med 2013 38(4):e160–5CrossRef

36.

Saby L, Le Dolley Y, Lass O et al (2012) Early diagnosis of abscess in aortic bioprosthetic valve by 18F-fluorodeoxyglucose positron emission tomography-computed tomography. Circulation 126(14):e217–20PubMedCrossRef

37.

Belli L, Magistretti G, Puricelli GP et al (1997) Arteritis following intra-arterial chemotherapy for liver tumors. Eur Radiol 7(3):323–6PubMedCrossRef

38.

Tso E, Flamm SD, White RD et al (2002) Takayasu arteritis: utility and limitations of magnetic resonance imaging in diagnosis and treatment. Arthritis Rheum 46(6):1634–42PubMedCrossRef

39.

Khan A, Dasgupta B (2015) Imaging in giant cell arteritis. Curr Rheumatol Rep 17:52PubMedCrossRef

40.

Blockmans D (2003) The use of (18F)fluoro-deoxyglucose positron emission tomography in the assessment of large vessel vasculitis. Clin Exp Rheumatol 21(6 Suppl 32):S15–22PubMed

41.

Einspieler I, Thurmel K, Eiber M et al (2014) Imaging large vessel vasculitis with fully integrated PET/MR: a pilot study. J Nucl Med 55(Supplement 1):185

42.

Balink H, Bennink RJ, van Eck-Smit BL et al (2014) The role of 18F-FDG PET/CT in large-vessel vasculitis: appropriateness of current classification criteria? Biomed Res Int 2014:687608PubMedPubMedCentralCrossRef

43.

Chu B, Ferguson MS, Chen H et al (2009) Magnetic resonance imaging features of the disruption-prone and the disrupted carotid plaque. JACC Cardiovasc Imaging 2(7):883–96PubMedPubMedCentralCrossRef

44.

Davies JR, Rudd JH, Weissberg P (2004) Molecular and metabolic imaging of atherosclerosis. J Nucl Med 45(11):1898–907PubMed

45.

Gaebe M, Pederson SF, Borgwardt L et al (2009) Molecular pathology in vulnerable carotid plaques: correlation with [18]-fluorodeoxyglucose positron emission tomography (FDG-PET). Eur J Vasc Endovasc Surg 37(6):714–21CrossRef

46.

Lee JS, Paeing JC (2015) Nuclear molecular imaging for vulnerable atherosclerotic plaques. Korean J Radiol 16(5):955–966PubMedPubMedCentralCrossRef

47.

Masteling MG, Zeebregts CJ, Tio RA et al (2011) High-resolution imaging of human atherosclerotic carotid plaques with micro 18F-FDG PET scanning exploring plaque vulnerability. J Nucl Cardiol 18(6):1066–75PubMedPubMedCentralCrossRef

48.

Ripa RS, Mnudsen A, Hag AM et al (2013) Feasibility of simultaneous PET/MR of the carotid artery: first clinical experience and comparison to PET/CT. Am J Nucl Med Mol Imaging 3(4):361–71PubMedPubMedCentral

49.

Greenwood JP, Maredia N, Younger JF et al (2012) Cardiovascular magnetic resonance and single-photon emission computed tomography for diagnosis of coronary heart disease (CE-MARC): a prospective trial. Lancet 379(9814):453–60PubMedPubMedCentralCrossRef

50.

Klocke FN, Baird MG, Lorell BJ et al (2003) ACC/AHA/ASNC guidelines for the clinical use of cardiac radionuclide imaging--executive summary: a report of the american college of cardiology/American heart association task force on practice guidelines (ACC/AHA/ASNC committee to revise the 1995 guidelines for the clinical use of cardiac radionuclide imaging). J Am Coll Cardiol 42(7):1318–33PubMedCrossRef

51.

Yoshinaga K, Chow BJ, Williams K et al (2006) What is the prognostic value of myocardial perfusion imaging using rubidium-82 positron emission tomography? J Am Coll Cardiol 48(5):1029–39PubMedCrossRef

52.

Siegrist PT, Husmann L, Knabenhans M et al (2008) (13)N-ammonia myocardial perfusion imaging with a PET/CT scanner: impact on clinical decision making and cost-effectiveness. Eur J Nucl Med Mol Imaging 35(5):889–95PubMedCrossRef

53.

Schmidt A, Azevedo CF, Cheng A et al (2007) Infarct tissue heterogeneity by magnetic resonance imaging identifies enhanced cardiac arrhythmia susceptibility in patients with left ventricular dysfunction. Circulation 115(15):2006–14PubMedPubMedCentralCrossRef

54.

Kim RJ, Albert TS, Wible JH et al (2008) Performance of delayed-enhancement magnetic resonance imaging with gadoversetamide contrast for the detection and assessment of myocardial infarction: an international, multicenter, double-blinded, randomized trial. Circulation 117(5):629–37PubMedCrossRef

55.

Kim RJ, Wu E, Rafael A et al (2000) The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. N Engl J Med 343(20):1445–53PubMedCrossRef

56.

Rajiah P, Desai MY, Kwon D, Flamm SD (2013) MR imaging of myocardial infartion. Radiographics 33(5):1383–412PubMedCrossRef

57.

Aletras AH, Tilak GS, Natanzon A et al (2006) Retrospective determination of the area at risk for reperfused acute myocardial infarction with T2-weighted cardiac magnetic resonance imaging: histopathological and displacement encoding with stimulated echoes (DENSE) functional validations. Circulation 113(15):1865–70PubMedCrossRef

58.

Schinkel AF, Pldermans D, Elhendy A et al (2007) Assessment of myocardial viability in patients with heart failure. J Nucl Med 48(7):1135–46PubMedCrossRef

59.

Underwood SR, Bax JJ, vom Dahl J et al (2004) Imaging techniques for the assessment of myocardial hibernation. Report of a Study Group of the European Society of Cardiology. Eur Heart J 25(10):815–36PubMedCrossRef

60.

Kuhl HP, Lipke CS, Krombach GA et al (2006) Assessment of reversible myocardial dysfunction in chronic ischaemic heart disease: comparison of contrast-enhanced cardiovascular magnetic resonance and a combined positron emission tomography-single photon emission computed tomography imaging protocol. Eur Heart J 27(7):846–53PubMedCrossRef

61.

Bellenger NG, Davies LC, Francis JM et al (2000) Reduction in sample size for studies of remodeling in heart failure by the use of cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2(4):271–8PubMedCrossRef

62.

Kato S, Kitagawa K, Ishida N et al (2010) Assessment of coronary artery disease using magnetic resonance coronary angiography: a national multicenter trial. J Am Coll Cardiol 56(12):983–91PubMedCrossRef

Title: Incremental value of PET and MRI in the evaluation of cardiovascular abnormalities
Authors: Hamid Chalian
James K. O’Donnell
Michael Bolen
Prabhakar Rajiah
Publication date: 01-08-2016
Publisher: Springer Berlin Heidelberg
Published in: Insights into Imaging / Issue 4/2016
Electronic ISSN: 1869-4101
DOI: https://doi.org/10.1007/s13244-016-0494-5

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Incremental value of PET and MRI in the evaluation of cardiovascular abnormalities

Abstract

Main Messages

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Main Messages

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