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Magn Reson Med. 2018 Dec;80(6):2641-2654. doi: 10.1002/mrm.27213. Epub 2018 Apr 19.

Myocardial perfusion quantification using simultaneously acquired 13 NH3 -ammonia PET and dynamic contrast-enhanced MRI in patients at rest and stress.

Author information

1
Klinikum rechts der Isar der TU München, Department of Nuclear Medicine, Munich, Germany.
2
DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany.
3
Brigham and Women's Hospital, Department of Radiology, Boston, United States.
4
Siemens Healthcare GmbH, Erlangen, Germany.
5
Klinikum rechts der Isar der TU München, Department of Cardiology, Munich, Germany.

Abstract

PURPOSE:

Systematic differences with respect to myocardial perfusion quantification exist between DCE-MRI and PET. Using the potential of integrated PET/MRI, this study was conceived to compare perfusion quantification on the basis of simultaneously acquired 13 NH3 -ammonia PET and DCE-MRI data in patients at rest and stress.

METHODS:

Twenty-nine patients were examined on a 3T PET/MRI scanner. DCE-MRI was implemented in dual-sequence design and additional T1 mapping for signal normalization. Four different deconvolution methods including a modified version of the Fermi technique were compared against 13 NH3 -ammonia results.

RESULTS:

Cohort-average flow comparison yielded higher resting flows for DCE-MRI than for PET and, therefore, significantly lower DCE-MRI perfusion ratios under the common assumption of equal arterial and tissue hematocrit. Absolute flow values were strongly correlated in both slice-average (R2  = 0.82) and regional (R2  = 0.7) evaluations. Different DCE-MRI deconvolution methods yielded similar flow result with exception of an unconstrained Fermi method exhibiting outliers at high flows when compared with PET.

CONCLUSION:

Thresholds for Ischemia classification may not be directly tradable between PET and MRI flow values. Differences in perfusion ratios between PET and DCE-MRI may be lifted by using stress/rest-specific hematocrit conversion. Proper physiological constraints are advised in model-constrained deconvolution.

KEYWORDS:

DCE-MRI; Fermi deconvolution; NH3-ammonia PET; PET/MRI; myocardial perfusion; perfusion quantification

PMID:
29672922
DOI:
10.1002/mrm.27213

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