Simultaneous  13 N-Ammonia and gadolinium first-pass myocardial perfusion with quantitative hybrid PET-MR imaging: a phantom and clinical feasibility study

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Positron emission tomography (PET) is the non-invasive reference standard for myocardial blood flow (MBF) quantification. Hybrid PET-MR allows simultaneous PET and cardiac magnetic resonance (CMR) acquisition under identical experimental and physiological conditions. This study aimed to determine feasibility of simultaneous ¹³N-Ammonia PET and dynamic contrast-enhanced CMR MBF quantification in phantoms and healthy volunteers.

Methods

Images were acquired using a 3T hybrid PET-MR scanner. Phantom study: MBF was simulated at different physiological perfusion rates and a protocol for simultaneous PET-MR perfusion imaging was developed. Volunteer study: five healthy volunteers underwent adenosine stress. ¹³N-Ammonia and gadolinium were administered simultaneously. PET list mode data was reconstructed using ordered subset expectation maximisation. CMR MBF was quantified using Fermi function-constrained deconvolution of arterial input function and myocardial signal. PET MBF was obtained using a one-tissue compartment model and image-derived input function.

Results

Phantom study: PET and CMR MBF measurements demonstrated high repeatability with intraclass coefficients 0.98 and 0.99, respectively. There was high correlation between PET and CMR MBF ( r = 0.98, p < 0.001) and good agreement (bias − 0.85 mL/g/min; 95% limits of agreement 0.29 to − 1.98). Volunteer study: Mean global stress MBF for CMR and PET were 2.58 ± 0.11 and 2.60 ± 0.47 mL/g/min respectively. On a per territory basis, there was moderate correlation ( r = 0.63, p = 0.03) and agreement (bias − 0.34 mL/g/min; 95% limits of agreement 0.49 to − 1.18).

Conclusion

Simultaneous MBF quantification using hybrid PET-MR imaging is feasible with high test repeatability and good to moderate agreement between PET and CMR. Future studies in coronary artery disease patients may allow cross-validation of techniques.

Electronic supplementary material

The online version of this article (10.1186/s41824-019-0062-6) contains supplementary material, which is available to authorized users.

Related collections

Most cited references 32

Record: found
Abstract: found
Article: found

Is Open Access

Quantification of myocardial perfusion by cardiovascular magnetic resonance

Michael Jerosch-Herold (2010)

The potential of contrast-enhanced cardiovascular magnetic resonance (CMR) for a quantitative assessment of myocardial perfusion has been explored for more than a decade now, with encouraging results from comparisons with accepted "gold standards", such as microspheres used in the physiology laboratory. This has generated an increasing interest in the requirements and methodological approaches for the non-invasive quantification of myocardial blood flow by CMR. This review provides a synopsis of the current status of the field, and introduces the reader to the technical aspects of perfusion quantification by CMR. The field has reached a stage, where quantification of myocardial perfusion is no longer a claim exclusive to nuclear imaging techniques. CMR may in fact offer important advantages like the absence of ionizing radiation, high spatial resolution, and an unmatched versatility to combine the interrogation of the perfusion status with a comprehensive tissue characterization. Further progress will depend on successful dissemination of the techniques for perfusion quantification among the CMR community.

0 comments Cited 60 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Fully quantitative cardiovascular magnetic resonance myocardial perfusion ready for clinical use: a comparison between cardiovascular magnetic resonance imaging and positron emission tomography

Henrik Engblom, Hui Xue, Shahnaz Akil … (2017)

Background Recent studies have shown that quantification of myocardial perfusion (MP) at stress and myocardial perfusion reserve (MPR) offer additional diagnostic and prognostic information compared to qualitative and semi-quantitative assessment of myocardial perfusion distribution in patients with coronary artery disease (CAD). Technical advancements have enabled fully automatic quantification of MP using cardiovascular magnetic resonance (CMR) to be performed in-line in a clinical workflow. The aim of this study was to validate the use of the automated CMR perfusion mapping technique for quantification of MP using 13N–NH3 cardiac positron emission tomography (PET) as the reference method. Methods Twenty-one patients with stable CAD were included in the study. All patients underwent adenosine stress and rest perfusion imaging with 13N–NH3 PET and a dual sequence, single contrast bolus CMR on the same day. Global and regional MP were quantified both at stress and rest using PET and CMR. Results There was good agreement between global MP quantified by PET and CMR both at stress (−0.1 ± 0.5 ml/min/g) and at rest (0 ± 0.2 ml/min/g) with a strong correlation (r = 0.92, p < 0.001; y = 0.94× + 0.14). Furthermore, there was strong correlation between CMR and PET with regards to regional MP (r = 0.83, p < 0.001; y = 0.87× + 0.26) with a good agreement (−0.1 ± 0.6 ml/min/g). There was also a significant correlation between CMR and PET with regard to global and regional MPR (r = 0.69, p = 0.001 and r = 0.57, p < 0.001, respectively). Conclusions There is good agreement between MP quantified by 13N–NH3 PET and dual sequence, single contrast bolus CMR in patients with stable CAD. Thus, CMR is viable in clinical practice for quantification of MP.

0 comments Cited 59 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Development of a universal dual-bolus injection scheme for the quantitative assessment of myocardial perfusion cardiovascular magnetic resonance

Masaki Ishida, Andreas Schuster, Geraint Morton … (2011)

Background The dual-bolus protocol enables accurate quantification of myocardial blood flow (MBF) by first-pass perfusion cardiovascular magnetic resonance (CMR). However, despite the advantages and increasing demand for the dual-bolus method for accurate quantification of MBF, thus far, it has not been widely used in the field of quantitative perfusion CMR. The main reasons for this are that the setup for the dual-bolus method is complex and requires a state-of-the-art injector and there is also a lack of post processing software. As a solution to one of these problems, we have devised a universal dual-bolus injection scheme for use in a clinical setting. The purpose of this study is to show the setup and feasibility of the universal dual-bolus injection scheme. Methods The universal dual-bolus injection scheme was tested using multiple combinations of different contrast agents, contrast agent dose, power injectors, perfusion sequences, and CMR scanners. This included 3 different contrast agents (Gd-DO3A-butrol, Gd-DTPA and Gd-DOTA), 4 different doses (0.025 mmol/kg, 0.05 mmol/kg, 0.075 mmol/kg and 0.1 mmol/kg), 2 different types of injectors (with and without "pause" function), 5 different sequences (turbo field echo (TFE), balanced TFE, k-space and time (k-t) accelerated TFE, k-t accelerated balanced TFE, turbo fast low-angle shot) and 3 different CMR scanners from 2 different manufacturers. The relation between the time width of dilute contrast agent bolus curve and cardiac output was obtained to determine the optimal predefined pause duration between dilute and neat contrast agent injection. Results 161 dual-bolus perfusion scans were performed. Three non-injector-related technical errors were observed (1.9%). No injector-related errors were observed. The dual-bolus scheme worked well in all the combinations of parameters if the optimal predefined pause was used. Linear regression analysis showed that the optimal duration for the predefined pause is 25s to separate the dilute and neat contrast agent bolus curves if 0.1 mmol/kg dose of Gd-DO3A-butrol is used. Conclusion The universal dual-bolus injection scheme does not require sophisticated double-head power injector function and is a feasible technique to obtain reasonable arterial input function curves for absolute MBF quantification.

0 comments Cited 58 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Muhummad Sohaib Nazir:

ORCID: http://orcid.org/0000-0003-2749-1033

sohaib.nazir@gmail.com

Sarah-May Gould: sara-may.gould@kcl.ac.uk

Xenios Milidonis: xenios.milidonis@kcl.ac.uk

Eliana Reyes: eliana.reyes@kcl.ac.uk

Tevfik F. Ismail: tevfik.ismail@kcl.ac.uk

Radhouene Neji: radhouene.neji@kcl.ac.uk

Sébastien Roujol: sebastien.roujol@kcl.ac.uk

Jim O’Doherty: jim.o'doherty@kcl.ac.uk

Hui Xue: hui.xue@nih.gov

Sally F. Barrington: sally.barrington@kcl.ac.uk

Tobias Schaeffter: tobias.schaeffter@ptb.de

Reza Razavi: reza.razavi@kcl.ac.uk

Paul Marsden: paul.marsden@kcl.ac.uk

Peter Kellman: kellmanp@nhlbi.nih.gov

Sven Plein: S.Plein@leeds.ac.uk

Amedeo Chiribiri: +44 (0)20 718 87242 , amedeo.chiribiri@kcl.ac.uk

Journal

Journal ID (nlm-ta): Eur J Hybrid Imaging

Journal ID (iso-abbrev): Eur J Hybrid Imaging

Title: European Journal of Hybrid Imaging

Publisher: Springer International Publishing (Cham )

ISSN (Electronic): 2510-3636

Publication date (Electronic): 3 September 2019

Publication date PMC-release: 3 September 2019

Publication date (Print): 2019

Volume: 3

Issue: 1

Electronic Location Identifier: 15

Affiliations

[1 ]ISNI 0000 0001 2322 6764, GRID grid.13097.3c, Department of Cardiovascular Imaging, School of Biomedical Engineering and Imaging Sciences, , King’s College London, St Thomas’ Hospital, Westminster Bridge, ; 4th Floor Lambeth Wing, London, SE1 7EH UK

[2 ]GRID grid.14601.32, Siemens Healthcare Limited, ; Sir William Siemens Square, Frimley, Camberley, GU16 8QD UK

[3 ]ISNI 0000 0001 2293 4638, GRID grid.279885.9, National Heart, Lung, and Blood Institute, National Institutes of Health, DHHS, ; Bethesda, MD USA

[4 ]ISNI 0000 0001 2186 1887, GRID grid.4764.1, Physikalisch-Technische Bundesanstalt, ; Berlin, Germany

[5 ]ISNI 0000 0004 1936 8403, GRID grid.9909.9, Leeds Institute of Cardiovascular and Metabolic Medicine, LIGHT Laboratories, Clarendon Way, , University of Leeds, ; Leeds, LS2 9JT UK

Author information

Muhummad Sohaib Nazir http://orcid.org/0000-0003-2749-1033

Article

Publisher ID: 62

DOI: 10.1186/s41824-019-0062-6

PMC ID: 6718374

SO-VID: 9d28f02d-6b22-4c6a-9187-2e59a8923f2b

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

History

Date received : 9 April 2019

Date accepted : 15 July 2019

Funding

Funded by: Medical Research Council

Award ID: MR/P01979X/1

Award Recipient : Muhummad Sohaib Nazir

Funded by: FundRef http://dx.doi.org/10.13039/501100000833, Rosetrees Trust;

Award ID: A1380

Award Recipient : Muhummad Sohaib Nazir

Custom metadata

Keywords: hybrid imaging,pet-mr,myocardial perfusion,myocardial blood flow

Data availability:

Keywords: hybrid imaging, pet-mr, myocardial perfusion, myocardial blood flow

Comments

Comment on this article

scite_

Cited by 3

See all cited by

Most referenced authors 474

See all reference authors