Viability assessment with MRI is superior to FDG-PET for viability: Con

Patterson, Randolph E.; Sigman, Steven R.; O’Donnell, Rachel; Eisner, Robert L.

doi:10.1007/s12350-010-9209-3

Cited by 13 publications

(9 citation statements)

References 65 publications

(182 reference statements)

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“…However, the prediction of functional recovery as assessed by quantification of the transmural extent of LGE (ie, scar) creates "shades of grey" in clinical interpretation. Patterson et al 45 reinterpreted the results of the paper by Kim et al 46 and reported contrastenhanced MR imaging is diagnostic in only 64% of segments.…”

Section: Performance For Myocardial Viability Assessmentmentioning

confidence: 94%

Cardiac Magnetic Resonance Imaging: Choice of the Year - Which Imaging Modality Is Best for Evaluation of Myocardial Ischemia? (MRI-Side) -

Cheung

Chan

2011

Circ J

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The increasing variety of available cardiac imaging techniques have made the investigation of coronary artery disease more complex. On the one hand, nuclear cardiology or myocardial perfusion imaging (MPI) allows accurate and reliable quantitative measurement of myocardial blood flow. On the other hand, a newer technique, cardiac magnetic resonance imaging (CMR) is an attractive alternative for achieving similar purposes without exposing patients to radiation hazards. With a higher spatial resolution, CMR is more sensitive for detecting subendocardial ischemia; small myocardial infarction and/or fibrosis, which cannot be achieved in a nuclear study. Nuclear MPI has dominated clinical practice over the past 3 decades on the basis of an extensive amount of research. More upcoming research on CMR would warrant more evidence-based data of its value for disease diagnosis, prognosis and risk stratification and incorporating it into the clinical diagnostic and management algorithm. (Circ J 2011; 75: 724 - 731)

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Section: Performance For Myocardial Viability Assessmentmentioning

confidence: 94%

Cardiac Magnetic Resonance Imaging: Choice of the Year - Which Imaging Modality Is Best for Evaluation of Myocardial Ischemia? (MRI-Side) -

Cheung

Chan

2011

Circ J

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“…3 and 4). However, discrepant findings between the 2 modalities with a mismatch between molecular (perfusion-metabolism) and functional (LGE, low dobutamine-enhanced contractility) evaluations is relatively frequent, occurring in 20%-36% of cases, and it remains unclear how these findings should be considered for the clinical management of these patients (30). More longitudinal controlled studies are needed to better understand the impact of these unmatched regional alterations on patient outcome and whether patients may require revascularization interventions.…”

Section: What Mr Imaging Can Bring To Cardiac Pet Imagingmentioning

confidence: 99%

Potential Applications of PET/MR Imaging in Cardiology

Ratib

Nkoulou

2014

J Nucl Med

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Recent advances in hybrid PET/MR imaging have opened new perspectives for cardiovascular applications. Although cardiac MR imaging has gained wider adoption for routine clinical applications, PET images remain the reference in many applications for which objective analysis of metabolic and physiologic parameters is needed. In particular, in cardiovascular diseases-more specifically, coronary artery disease-the use of quantitative and measurable parameters in a reproducible way is essential for the management of therapeutic decisions and patient follow-up. Functional MR images and dynamic assessment of myocardial perfusion from transit of intravascular contrast medium can provide useful criteria for identifying areas of decreased myocardial perfusion or for assessing tissue viability from late contrast enhancement of scar tissue. PET images, however, will provide more quantitative data on true tissue perfusion and metabolism. Quantitative myocardial flow can also lead to accurate assessment of coronary flow reserve. The combination of both modalities will therefore provide complementary data that can be expected to improve the accuracy and reproducibility of diagnostic procedures. But the true potential of hybrid PET/MR imaging may reside in applications beyond the domain of coronary artery disease. The combination of both modalities in assessment of other cardiac diseases such as inflammation and of other systemic diseases can also be envisioned. It is also predicted that the 2 modalities combined could help characterize atherosclerotic plaques and differentiate plaques with a high risk of rupture from stable plaques. In the future, the development of new tracers will also open new perspectives in evaluating myocardial remodeling and in assessing the kinetics of stem cell therapy in myocardial infarction. New tracers will also provide new means for evaluating alterations in cardiac innervation, angiogenesis, and even the assessment of reporter gene technologies. The fusion of 2 potentially competing modalities can certainly offer the best of each modality in a single procedure. The impact of such advanced technology in routine clinical practice will still need to be demonstrated. Beyond the expected improvement in patient management and the potential impact on patient outcome, PET/MR imaging will also need to establish its medicoeconomic justification in an era of health-care economic restrictions. Theemer gence of hybrid PET/CT more than a decade ago has changed the perspective on the applicability of PET in clinical routines. The added value of anatomic localization and morphologic characterization provided by CT images allowed a better confidence in PET image interpretation and diagnostic accuracy, yielding a wider adoption of PET investigation in clinical practice. Although mostly driven by oncologic applications, the wider availability of PET/CT scanners has led to its broader access for other applications such as cardiology and neurology. Despite limitations in reimbursements, the progressive increase in P...

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“…Flow/FDG PET in the latter situation would be expected to show the typical mismatch pattern. Patterson et al 55 has commented on the study of Kim et al 40 stating that there is a 36% rate of indeterminacy due to exactly this issue with LGE CMR alone, viz: the characterization of the non-enhancing myocardium in patients with transmurality between 25% and 75%. Roes et al 54 commented that only 53% of segments with subendocardial scar with 1%-50% transmurality in the study of Kim et al 40 showed functional recovery.…”

Section: Cmr Imagingmentioning

confidence: 99%

“…55,172 Others have called LGE CMR images (top panel), FDG PET images (bottom panel), and co-registered images (center). CMR shows subendocardial anterior wall and apical enhancement.…”

Section: Are Trial Designs Originally Utilized For Evaluating Treatmementioning

confidence: 99%

Noninvasive assessment myocardial viability: Current status and future directions

Allman

2013

Journal of Nuclear Cardiology

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Observations of reversibility of cardiac contractile dysfunction in patients with coronary artery disease and ischemia were first made more than 40 years ago. Since that time a wealth of basic science and clinical data has been gathered exploring the mechanisms of this phenomenon of myocardial viability and relevance to clinical care of patients. Advances in cardiac imaging techniques have contributed greatly to knowledge in the area, first with thallium-201 imaging, then later with Tc-99m-based tracers for SPECT imaging and metabolic tracers used in conjunction with positron emission tomography (PET), most commonly F-18 FDG in conjunction with blood flow imaging with N-13 ammonia or Rb-82 Cl. In parallel, stress echocardiography has made great progress also. Over time observational studies in patients using these techniques accumulated and were later summarized in several meta-analyses. More recently, cardiac magnetic resonance imaging (CMR) has contributed further information in combination with either late gadolinium enhancement imaging or dobutamine stress. This review discusses the tracer and CMR imaging techniques, the pooled observational data, the results of clinical trials, and ongoing investigation in the field. It also examines some of the current challenges and issues for researchers and explores the emerging potential of combined PET/CMR imaging for myocardial viability.

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Viability assessment with MRI is superior to FDG-PET for viability: Con

Cited by 13 publications

References 65 publications

Cardiac Magnetic Resonance Imaging: Choice of the Year - Which Imaging Modality Is Best for Evaluation of Myocardial Ischemia? (MRI-Side) -

Cardiac Magnetic Resonance Imaging: Choice of the Year - Which Imaging Modality Is Best for Evaluation of Myocardial Ischemia? (MRI-Side) -

Potential Applications of PET/MR Imaging in Cardiology

Noninvasive assessment myocardial viability: Current status and future directions

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