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Updated: Jan 3, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Sequential PET/diffusion-weighted imaging in the evaluation of myocardial perfusion and viability in coronary artery
Xueying Ling1, Jianxin Chen2, Jingjie Shang1
1Department of Nuclear Medicine.
Insights
Sequential F-18 fluorodeoxyglucose PET/diffusion-weighted imaging shows promise for assessing myocardial perfusion and viability in coronary artery disease. This novel approach demonstrates comparable results to traditional methods, offering a potentially valuable tool for patient evaluation.
Area of Science:
- Cardiovascular Imaging
- Nuclear Medicine
- Radiology
Background:
- Coronary artery disease (CAD) necessitates accurate assessment of myocardial perfusion and viability.
- Traditional methods like SPECT/PET imaging are established but novel techniques are being explored.
- Diffusion-weighted imaging (DWI) offers insights into tissue microstructural changes.
Purpose of the Study:
- To evaluate the utility of sequential F-18 fluorodeoxyglucose (FDG) PET/diffusion-weighted imaging (DWI) in assessing myocardial perfusion and viability in patients with coronary artery disease.
- To compare the diagnostic performance of low b-values apparent diffusion coefficient (ADC) derived perfusion with traditional myocardial perfusion imaging.
Main Methods:
- Sequential cardiac F-18 FDG PET/DWI was performed using a trimodality PET/CT-MRI system in 14 CAD patients and 5 controls.
- Myocardial perfusion was assessed by measuring low b-values ADC, and viability by F-18 FDG uptake.
- Results were compared with rest methoxyisobutylisonitrile (Tc-MIBI) SPECT/F-18 FDG PET.
Main Results:
- Low b-values ADC defects were identified in 9 CAD patients, comparable to Tc-MIBI defects in 21 regions.
- Good agreement was observed between low b-values ADC and MIBI uptake (κ = 0.627 in CAD patients, κ = 0.733 in all subjects).
- High agreement was found in assessing regional myocardial viability between low b-values ADC/F-18 FDG and MIBI/F-18 FDG (κ = 0.627 in CAD patients, κ = 0.728 in all subjects).
Conclusions:
- Sequential F-18 FDG PET/DWI using low b-values ADC is comparable to Tc-MIBI/F-18 FDG PET for assessing myocardial perfusion/metabolism patterns.
- The findings suggest that microperfusion may influence the diffusion signal at low b-values.
- Sequential PET/DWI represents a potentially useful tool for evaluating myocardial viability in CAD patients.
Objectives:
To evaluate the utility of sequential F-18 fluorodeoxyglucose PET/diffusion-weighted imaging in assessing myocardial perfusion and viability in coronary artery disease.
Methods:
Fourteen coronary artery disease patients and five non-coronary artery disease subjects underwent sequential cardiac F-18 fluorodeoxyglucose PET/diffusion-weighted imaging using a trimodality PET/computed tomography-MRI system. The perfusion data were acquired by measuring low b-values apparent diffusion coefficient using diffusion-weighted imaging. Regional myocardial viability was determined by perfusion/metabolism patterns. The perfusion/metabolism patterns obtained by low b-values apparent diffusion coefficient/fluorodeoxyglucose uptake were analyzed and compared with the results from the combination of rest methoxyisobutylisonitrile (Tc-MIBI) myocardial perfusion single-photon emission computed tomography with F-18 fluorodeoxyglucose PET/computed tomography.
Results:
Ten coronary artery disease patients and five non-coronary artery disease subjects were included in the final analysis. Low b-values apparent diffusion coefficient defects involved with 25 myocardial regions were demonstrated in nine coronary artery disease patients, while Tc-MIBI defects involved with 21 myocardial regions were shown in the same patients. The agreement between low b-values apparent diffusion coefficient and MIBI uptake was good in coronary artery disease patients (κ = 0.627, P < 0.001) and was better still in the whole subjects (κ = 0.733, P < 0.001). Low b-values apparent diffusion coefficient/fluorodeoxyglucose uptake demonstrated mismatch patterns in six coronary artery disease patients and MIBI/fluorodeoxyglucose uptake revealed mismatch patterns in seven coronary artery disease patients. Agreement in the evaluation of regional myocardial viability between low b-values apparent diffusion coefficient/fluorodeoxyglucose uptake and MIBI/fluorodeoxyglucose uptake was high in coronary artery disease patients (κ = 0.627, P < 0.001) and all subjects (κ = 0.728, P < 0.001).
Conclusions:
Low b-values apparent diffusion coefficient/fluorodeoxyglucose uptake is comparable to MIBI/fluorodeoxyglucose uptake in assessing perfusion/metabolism patterns, indicating that microperfusion might dominate the diffusion signal at low b-values and sequential PET/diffusion-weighted imaging might be useful to evaluate myocardial viability in coronary artery disease patients.
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