Abstract 11929: Simultaneous Assessment of Myocardial Viability With 18F-fluorodeoxyglucose Uptake and Late Gadolinium Enhancement by PET/MRI
Introduction: Both 18F-fluorodeoxyglucose (FDG) PET and late gadolinium enhancement on cardiac MRI (LGE-CMR) have been utilized for myocardial viability evaluation. However, the association between these 2 modalities has not been fully investigated. The aim of this study was to compare FDG PET and LGE-MRI findings simultaneously using an integrated PET/MRI.
Methods: Twelve participants (age 68.8 ± 7.9 years old, 11 males, left ventricular ejection fraction 40.5 ± 15.0%) with old myocardial infarction were enrolled. Total 204 segments were analyzed according to the 17-segment model. FDG PET/MRI was performed for each participant under hyperinsulinaemic-euglycemic state. The FDG uptake was semiquantitatively measured as %uptake. The transmural extent of LGE-CMR was evaluated by a 5-point scoring system (0 = 0%, 1 = 1-25%, 2 = 26-50%, 3 = 51-75%, 4 = 76-100%). Left ventricular (LV) wall thickness at end-diastolic phase and LV wall thickening were also measured by CMR. Viable myocardium was defined as less than 50% of the transmural extent of LGE-CMR.
Results: Relative FDG uptake and the transmural extent of LGE-CMR were significantly correlated (P < 0.0001, Spearman ρ = -0.63). Relative FDG uptake was correlated with LV wall thickness (P = 0.003, ρ = 0.22) and LV wall thickening (P < 0.0001, ρ = 0.59). Receiver operating characteristic analysis demonstrated that the best cut-off value of FDG uptake to predict myocardial viability was 63% (area under the curve 0.90). When the cut-off value set to 63%, sensitivity was 81.6%, specificity was 80.8%, and accuracy was 81.4%.
Conclusions: Relative FDG uptake was comparable to the transmural extent of LGE-CMR in assessing myocardial viability. Simultaneous evaluation using the integrated PET/MRI is feasible and may provide novel insights into evaluation of the myocardial viability.
Author Disclosures: A. Masuda: None. T. Yamaki: None. H. Kunii: None. T. Nanbu: None. T. Hara: None. H. Kubo: None. H. Ito: None. S. Takenoshita: None. Y. Takeishi: None.
- © 2016 by American Heart Association, Inc.