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

Andrews, Jack; Macnaught, Gillian; Moss, Alastair J; Doris, Mhairi; Pawade, Tania; Adamson, Philip D; Beek, Edwin Jacques Rudolph van; Lucatelli, Christophe; Lassen, Martin Lyngby; Robson, Philip M.; Fayad, Zahi A.; Kwieciński, Jacek; Slomka, Piotr J.; Berman, Daniel S.; Newby, David E.; Dweck, Marc R

doi:10.1007/s12350-019-01962-y

Cited by 19 publications

(19 citation statements)

References 27 publications

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“…Furthermore, as depicted in Fig. 5 and shown by previous studies [7], the MR signal voids caused by stents do prevent the use of the MR as anatomic information to precisely locate uptake. Potential errors, however, that propagate into the MR-based AC map could be efficiently and automatically dealt with by morphological transformations and inpainting.…”

Section: Discussionmentioning

confidence: 76%

“…Both hybrid modalities PET/CT [1,4,5] and PET/MR [6,7] have been shown to provide a good assessment of coronary [ 18 F]NaF uptake. A comprehensive comparison between both hybrid modalities [7] found equally successful plaque identification in aortic valves and coronary arteries. Yet, both hybrid modalities suffer from the main challenge of cardiac PET in clinical applications: the impairing effect of physiological heart motion due to both respiration and cardiac movement.…”

Section: Introductionmentioning

confidence: 99%

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Imaging coronary plaques using 3D motion-compensated [18F]NaF PET/MR

Mayer

Wurster

Schaeffter

et al. 2021

Eur J Nucl Med Mol Imaging

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Background Cardiac PET has recently found novel applications in coronary atherosclerosis imaging using [18F]NaF as a radiotracer, highlighting vulnerable plaques. However, the resulting uptakes are relatively small, and cardiac motion and respiration-induced movement of the heart can impair the reconstructed images due to motion blurring and attenuation correction mismatches. This study aimed to apply an MR-based motion compensation framework to [18F]NaF data yielding high-resolution motion-compensated PET and MR images. Methods Free-breathing 3-dimensional Dixon MR data were acquired, retrospectively binned into multiple respiratory and cardiac motion states, and split into fat and water fraction using a model-based reconstruction framework. From the dynamic MR reconstructions, both a non-rigid cardiorespiratory motion model and a motion-resolved attenuation map were generated and applied to the PET data to improve image quality. The approach was tested in 10 patients and focal tracer hotspots were evaluated concerning their target-to-background ratio, contrast-to-background ratio, and their diameter. Results MR-based motion models were successfully applied to compensate for physiological motion in both PET and MR. Target-to-background ratios of identified plaques improved by 7 ± 7%, contrast-to-background ratios by 26 ± 38%, and the plaque diameter decreased by −22 ± 18%. MR-based dynamic attenuation correction strongly reduced attenuation correction artefacts and was not affected by stent-related signal voids in the underlying MR reconstructions. Conclusions The MR-based motion correction framework presented here can improve the target-to-background, contrast-to-background, and width of focal tracer hotspots in the coronary system. The dynamic attenuation correction could effectively mitigate the risk of attenuation correction artefacts in the coronaries at the lung-soft tissue boundary. In combination, this could enable a more reproducible and reliable plaque localisation.

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Section: Discussionmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Imaging coronary plaques using 3D motion-compensated [18F]NaF PET/MR

Mayer

Wurster

Schaeffter

et al. 2021

Eur J Nucl Med Mol Imaging

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“…In general, the use of attenuation correction methods incorporating bone should be encouraged when they become available (96). When available, the use of free-breathing radial VIBE sequences for AC is encouraged since these AC sequences appear to reduce breathing and motion artifacts (97). Particular caution is warranted in case of MR-compatible, implanted material such as stents or sternal wires, as these can lead to incorrect attenuation maps and thus to incorrect attenuation-corrected PET data (98).…”

Section: Pet/mr Procedurals In 4ismentioning

confidence: 99%

Procedural recommendations of cardiac PET/CT imaging: standardization in inflammatory-, infective-, infiltrative-, and innervation (4Is)-related cardiovascular diseases: a joint collaboration of the EACVI and the EANM

Slart

Glaudemans

Gheysens

et al. 2020

Eur J Nucl Med Mol Imaging

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With this document, we provide a standard for PET/(diagnostic) CT imaging procedures in cardiovascular diseases that are inflammatory, infective, infiltrative, or associated with dysfunctional innervation (4Is). This standard should be applied in clinical practice and integrated in clinical (multicenter) trials for optimal procedural standardization. A major focus is put on procedures using [18F]FDG, but 4Is PET radiopharmaceuticals beyond [18F]FDG are also described in this document. Whilst these novel tracers are currently mainly applied in early clinical trials, some multicenter trials are underway and we foresee in the near future their use in clinical care and inclusion in the clinical guidelines. Finally, PET/MR applications in 4Is cardiovascular diseases are also briefly described. Diagnosis and management of 4Is-related cardiovascular diseases are generally complex and often require a multidisciplinary approach by a team of experts. The new standards described herein should be applied when using PET/CT and PET/MR, within a multimodality imaging framework both in clinical practice and in clinical trials for 4Is cardiovascular indications.

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“…Unfortunately, patient motion during imaging protocols with long acquisition times degrades the image quality of the scans [ 10 ] and consequently reduces the quantitative accuracy and the test–retest repeatability [ 11 , 12 ]. In addition, variations in the tracer injection-to-scan delays affect the quantitative assessment of the lesions with 18 F-NaF PET [ 13 – 15 ]. While the impact of these factors is of keen interest in studies of aortic valve microcalcification, to date, it has been only evaluated in studies of coronary plaques [ 10 – 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, variations in the tracer injection-to-scan delays affect the quantitative assessment of the lesions with 18 F-NaF PET [ 13 – 15 ]. While the impact of these factors is of keen interest in studies of aortic valve microcalcification, to date, it has been only evaluated in studies of coronary plaques [ 10 – 15 ]. Best possible image quality and spatial resolution are of critical importance in studies of microcalcification in native valves to understand the pathophysiology of aortic stenosis, and in studies of bioprosthetic valves where accurate localization of 18 F-NaF uptake is essential.…”

Section: Introductionmentioning

confidence: 99%

Aortic valve imaging using 18F-sodium fluoride: impact of triple motion correction

et al. 2022

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Background Current 18F-NaF assessments of aortic valve microcalcification using 18F-NaF PET/CT are based on evaluations of end-diastolic or cardiac motion-corrected (ECG-MC) images, which are affected by both patient and respiratory motion. We aimed to test the impact of employing a triple motion correction technique (3 × MC), including cardiorespiratory and gross patient motion, on quantitative and qualitative measurements. Materials and methods Fourteen patients with aortic stenosis underwent two repeat 30-min PET aortic valve scans within (29 ± 24) days. We considered three different image reconstruction protocols; an end-diastolic reconstruction protocol (standard) utilizing 25% of the acquired data, an ECG-gated (four ECG gates) reconstruction (ECG-MC), and a triple motion-corrected (3 × MC) dataset which corrects for both cardiorespiratory and patient motion. All datasets were compared to aortic valve calcification scores (AVCS), using the Agatston method, obtained from CT scans using correlation plots. We report SUVmax values measured in the aortic valve and maximum target-to-background ratios (TBRmax) values after correcting for blood pool activity. Results Compared to standard and ECG-MC reconstructions, increases in both SUVmax and TBRmax were observed following 3 × MC (SUVmax: Standard = 2.8 ± 0.7, ECG-MC = 2.6 ± 0.6, and 3 × MC = 3.3 ± 0.9; TBRmax: Standard = 2.7 ± 0.7, ECG-MC = 2.5 ± 0.6, and 3 × MC = 3.3 ± 1.2, all p values ≤ 0.05). 3 × MC had improved correlations (R2 value) to the AVCS when compared to the standard methods (SUVmax: Standard = 0.10, ECG-MC = 0.10, and 3 × MC = 0.20; TBRmax: Standard = 0.20, ECG-MC = 0.28, and 3 × MC = 0.46). Conclusion 3 × MC improves the correlation between the AVCS and SUVmax and TBRmax and should be considered in PET studies of aortic valves using 18F-NaF.

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

Cited by 19 publications

References 27 publications

Imaging coronary plaques using 3D motion-compensated [18F]NaF PET/MR

Imaging coronary plaques using 3D motion-compensated [18F]NaF PET/MR

Procedural recommendations of cardiac PET/CT imaging: standardization in inflammatory-, infective-, infiltrative-, and innervation (4Is)-related cardiovascular diseases: a joint collaboration of the EACVI and the EANM

Aortic valve imaging using 18F-sodium fluoride: impact of triple motion correction

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