Evaluation of quantitative CMR perfusion imaging by comparison with simultaneous 15O-water-PET

Abstract

Background. We assessed the quantitative accuracy of cardiac perfusion measurements using dynamic contrast-enhanced MRI with simultaneous 15 O-water PET as reference with a fully integrated PET-MR scanner.Methods. 15 patients underwent simultaneous DCE MRI and 15 O-water PET scans at rest and adenosine-stress on an integrated PET-MR scanner. Correlation and agreement between MRI-and PET-based global and regional MBF values were assessed using correlation and Bland-Altman analysis.Results. Three subjects were excluded due to technical problems. Global mean (± SD) MBF values at rest and stress were 0.97 ± 0.27 and 3.19 ± 0.70 mL/g/min for MRI and 1.02 ± 0.28 and 3.13 ± 1.16 mL/g/min for PET (P = 0.66 and P = 0.81). The correlations between global and regional MRI-and PET-based MBF values were strong (r = 0.86 and r = 0.75). The biases were negligible for both global and regional MBF comparisons (0.01 and 0.00 mL/min/g for both), but the limits of agreement were wide for both global and regional MBF, with larger variability for high MBF-values.Conclusion. The correlation between simultaneous MBF measurements with DCE MRI and 15 O-water PET measured in an integrated PET-MRI was strong but the agreement was only moderate indicating that MRI-based quantitative MBF measurements is not ready for clinical introduction.

Clinical quantitative cardiac imaging for the assessment of myocardial ischaemia

“…Both 15 O-water and 13 N-ammonia require the presence of an on-site cyclotron as a high upfront investment because of the short half-lives of both tracers (2 min and 9 min, respectively). By contrast, Tc-MIBI-SPECT 66,[189][190][191][192] . Note that the 82 Rb and 99m Tc curves overlap.…”

Diagnosis of left ventricular hypertrophy using non-ECG-gated 15O-water PET

“…These subjects underwent both rest and adenosine-induced stress scans in one session, as previously described. 20 , 21 Ten of the 24 subjects additionally underwent DST imaging as part of the original protocol, which were used for method development (“DST-CAD”). The remaining 23 subjects in the comparison with CMR were diagnosed with asymptomatic moderate-severe or severe mitral- or aortic regurgitation and were consecutively included into an on-going prospective outcome study.…”

“…These subjects underwent both rest and adenosine-induced stress scans in one session, as previously described. 20 , 21 Ten of the 24 subjects additionally underwent DST imaging as part of the original protocol, which were used for method development (“DST-CAD”).…”

PET‐MRI of Coronary Artery Disease

“…In a small study of 15 patients, Kero et al assessed 15 O-water PET-MRI myocardial blood flow and found a good correlation and moderate agreement with simultaneous dynamic contrast-enhanced MRI assessments of myocardial blood flow. 12 Further work is required to assess how PET-MRI myocardial perfusion can be integrated with the other structural and functional information available from MRI imaging (Fig. 3).…”