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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
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Myocardial viability with chronic total occlusion assessed by hybrid positron emission tomography/magnetic resonance

Takatoyo Kiko1, Tetsuro Yokokawa2, Tomofumi Misaka2

  • 1Department of Cardiovascular Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan. tkiko@fmu.ac.jp.

Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology
|February 1, 2020
PubMed

Insights

Hybrid positron emission tomography/magnetic resonance imaging (PET/MRI) effectively predicts left ventricular function recovery in coronary chronic total occlusion (CTO) patients undergoing percutaneous coronary intervention (PCI). Simultaneous assessment of 18F-fluorodeoxyglucose (FDG) uptake and late gadolinium enhancement (LGE) improves prediction accuracy.

Area of Science:

  • Cardiovascular Imaging
  • Nuclear Cardiology
  • Cardiac MRI

Background:

  • Coronary chronic total occlusion (CTO) poses challenges for left ventricular (LV) function assessment.
  • Hybrid imaging combining 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and magnetic resonance imaging (MRI) offers a comprehensive approach.
  • Understanding the relationship between metabolic activity (FDG uptake) and scar burden (late gadolinium enhancement - LGE) is crucial for predicting functional recovery.

Purpose of the Study:

  • To compare the relationship between FDG uptake, LGE transmurality, and improvement in LV function in CTO patients.
  • To evaluate the predictive value of hybrid FDG PET/MRI for functional recovery after percutaneous coronary intervention (PCI).

Main Methods:

  • Thirty-eight CTO patients underwent baseline FDG PET/MRI.
  • Fifteen patients with baseline and follow-up MRI data were analyzed after PCI.
  • Myocardial segments were assessed for wall motion abnormalities and categorized based on FDG uptake (viable/nonviable) and LGE transmurality (viable/nonviable).

Main Results:

  • A significant inverse correlation was observed between FDG uptake and LGE transmurality across 646 myocardial segments.
  • Segments identified as PET-viable/MRI-viable showed the highest functional recovery post-PCI.
  • Segments identified as PET-nonviable/MRI-nonviable showed the lowest functional recovery; no significant difference was found between PET-viable/MRI-nonviable and PET-nonviable/MRI-viable segments.

Conclusions:

  • Simultaneous assessment of FDG uptake and LGE using hybrid PET/MRI is a valuable tool.
  • This hybrid imaging approach can effectively predict myocardial functional recovery after PCI in CTO patients.
Abstract

Keywords:
CADMRIPEThybrid imaging

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