Myocardial perfusion quantification using simultaneously acquired 13NH3-ammonia PET and dynamic contrast-enhanced MRI in patients at rest and stress
Corresponding Author
Karl P. Kunze
Klinikum rechts der Isar der TU München, Department of Nuclear Medicine, Munich, Germany
Funding information: The study was supported by Deutsche Forschungsgemeinschaft (DFG) through DFG grant #8810001759 and the DFG major equipment initiative. Additional Funding was provided by the European Research Council, ERC grant #294582 MUMI and the Whitaker International Fellows and Scholars Program. Carmel Hayes is an employee of Siemens Healthcare GmbH, Stephan G. Nekolla and Markus Schwaiger receive research support from Siemens Healthcare GmbH
Correspondence Karl P. Kunze, Department of Nuclear Medicine, Klinikum rechts der Isar, TU München, Ismaninger Straße 22 D-81675 Munich, Germany. Email: [email protected]Search for more papers by this authorStephan G. Nekolla
Klinikum rechts der Isar der TU München, Department of Nuclear Medicine, Munich, Germany
DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany
Funding information: The study was supported by Deutsche Forschungsgemeinschaft (DFG) through DFG grant #8810001759 and the DFG major equipment initiative. Additional Funding was provided by the European Research Council, ERC grant #294582 MUMI and the Whitaker International Fellows and Scholars Program. Carmel Hayes is an employee of Siemens Healthcare GmbH, Stephan G. Nekolla and Markus Schwaiger receive research support from Siemens Healthcare GmbH
Search for more papers by this authorChristoph Rischpler
Klinikum rechts der Isar der TU München, Department of Nuclear Medicine, Munich, Germany
DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany
Search for more papers by this authorShelley HuaLei Zhang
Brigham and Women's Hospital, Department of Radiology, Boston, United States
Search for more papers by this authorNicolas Langwieser
DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany
Klinikum rechts der Isar der TU München, Department of Cardiology, Munich, Germany
Search for more papers by this authorTareq Ibrahim
DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany
Klinikum rechts der Isar der TU München, Department of Cardiology, Munich, Germany
Search for more papers by this authorKarl-Ludwig Laugwitz
DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany
Klinikum rechts der Isar der TU München, Department of Cardiology, Munich, Germany
Search for more papers by this authorMarkus Schwaiger
Klinikum rechts der Isar der TU München, Department of Nuclear Medicine, Munich, Germany
DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany
Search for more papers by this authorCorresponding Author
Karl P. Kunze
Klinikum rechts der Isar der TU München, Department of Nuclear Medicine, Munich, Germany
Funding information: The study was supported by Deutsche Forschungsgemeinschaft (DFG) through DFG grant #8810001759 and the DFG major equipment initiative. Additional Funding was provided by the European Research Council, ERC grant #294582 MUMI and the Whitaker International Fellows and Scholars Program. Carmel Hayes is an employee of Siemens Healthcare GmbH, Stephan G. Nekolla and Markus Schwaiger receive research support from Siemens Healthcare GmbH
Correspondence Karl P. Kunze, Department of Nuclear Medicine, Klinikum rechts der Isar, TU München, Ismaninger Straße 22 D-81675 Munich, Germany. Email: [email protected]Search for more papers by this authorStephan G. Nekolla
Klinikum rechts der Isar der TU München, Department of Nuclear Medicine, Munich, Germany
DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany
Funding information: The study was supported by Deutsche Forschungsgemeinschaft (DFG) through DFG grant #8810001759 and the DFG major equipment initiative. Additional Funding was provided by the European Research Council, ERC grant #294582 MUMI and the Whitaker International Fellows and Scholars Program. Carmel Hayes is an employee of Siemens Healthcare GmbH, Stephan G. Nekolla and Markus Schwaiger receive research support from Siemens Healthcare GmbH
Search for more papers by this authorChristoph Rischpler
Klinikum rechts der Isar der TU München, Department of Nuclear Medicine, Munich, Germany
DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany
Search for more papers by this authorShelley HuaLei Zhang
Brigham and Women's Hospital, Department of Radiology, Boston, United States
Search for more papers by this authorNicolas Langwieser
DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany
Klinikum rechts der Isar der TU München, Department of Cardiology, Munich, Germany
Search for more papers by this authorTareq Ibrahim
DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany
Klinikum rechts der Isar der TU München, Department of Cardiology, Munich, Germany
Search for more papers by this authorKarl-Ludwig Laugwitz
DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany
Klinikum rechts der Isar der TU München, Department of Cardiology, Munich, Germany
Search for more papers by this authorMarkus Schwaiger
Klinikum rechts der Isar der TU München, Department of Nuclear Medicine, Munich, Germany
DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung e.V.) partner site Munich Heart Alliance, Munich, Germany
Search for more papers by this authorKarl P. Kunze and Stephan G. Nekolla contributed equally to this work.
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 13NH3-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 13NH3-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.
CONFLICT OF INTEREST
Carmel Hayes is an employee of Siemens Healthcare GmbH, Stephan G. Nekolla and Markus Schwaiger receive research support from Siemens Healthcare GmbH.
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