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European Journal of Nuclear Medicine and Molecular Imaging

Open Access 08-03-2024 | Positron Emission Tomography | Original Article

Thoracic aortic microcalcification activity in combined positron emission tomography and magnetic resonance imaging

Authors: Jennifer Nash, Samuel Debono, Beth Whittington, Jakub Kaczynski, Tim Clark, Gillian Macnaught, Scott Semple, Edwin J R van Beek, Adriana Tavares, Damini Dey, Michelle C Williams, Piotr J Slomka, David E Newby, Marc R Dweck, Alexander J Fletcher

Published in: European Journal of Nuclear Medicine and Molecular Imaging

Abstract

Introduction

Non-invasive detection of pathological changes in thoracic aortic disease remains an unmet clinical need particularly for patients with congenital heart disease. Positron emission tomography combined with magnetic resonance imaging (PET-MRI) could provide a valuable low-radiation method of aortic surveillance in high-risk groups. Quantification of aortic microcalcification activity using sodium [¹⁸F]fluoride holds promise in the assessment of thoracic aortopathies. We sought to evaluate aortic sodium [¹⁸F]fluoride uptake in PET-MRI using three methods of attenuation correction compared to positron emission tomography computed tomography (PET-CT) in patients with bicuspid aortic valve,

Methods

Thirty asymptomatic patients under surveillance for bicuspid aortic valve disease underwent sodium [¹⁸F]fluoride PET-CT and PET-MRI of the ascending thoracic aorta during a single visit. PET-MRI data were reconstructed using three iterations of attenuation correction (Dixon, radial gradient recalled echo with two [RadialVIBE-2] or four [RadialVIBE-4] tissue segmentation). Images were qualitatively and quantitatively analysed for aortic sodium [¹⁸F]fluoride uptake on PET-CT and PET-MRI.

Results

Aortic sodium [¹⁸F]fluoride uptake on PET-MRI was visually comparable with PET-CT using each reconstruction and total aortic standardised uptake values on PET-CT strongly correlated with each PET-MRI attenuation correction method (Dixon R = 0.70; RadialVIBE-2 R = 0.63; RadialVIBE-4 R = 0.64; p < 0.001 for all). Breathing related artefact between soft tissue and lung were detected using Dixon and RadialVIBE-4 but not RadialVIBE-2 reconstructions, with the presence of this artefact adjacent to the atria leading to variations in blood pool activity estimates. Consequently, quantitative agreements between radiotracer activity on PET-CT and PET-MRI were most consistent with RadialVIBE-2.

Conclusion

Ascending aortic microcalcification analysis in PET-MRI is feasible with comparable findings to PET-CT. RadialVIBE-2 tissue attenuation correction correlates best with the reference standard of PET-CT and is less susceptible to artefact. There remain challenges in segmenting tissue types in PET-MRI reconstructions, and improved attenuation correction methods are required.

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Title: Thoracic aortic microcalcification activity in combined positron emission tomography and magnetic resonance imaging
Authors: Jennifer Nash
Samuel Debono
Beth Whittington
Jakub Kaczynski
Tim Clark
Gillian Macnaught
Scott Semple
Edwin J R van Beek
Adriana Tavares
Damini Dey
Michelle C Williams
Piotr J Slomka
David E Newby
Marc R Dweck
Alexander J Fletcher
Publication date: 08-03-2024
Publisher: Springer Berlin Heidelberg
Keywords: Positron Emission Tomography
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-024-06670-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Thoracic aortic microcalcification activity in combined positron emission tomography and magnetic resonance imaging

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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