Evaluation of a low-carbohydrate diet-based preparation protocol without fasting for cardiac PET/MR imaging

Nensa, Felix; Tezgah, Ercan; Schweins, K.; Goebel, Juliane; Heusch, Philipp; Naßenstein, Kai; Schlosser, Thomas; Poeppel, Thorsten D.

doi:10.1007/s12350-016-0443-1

Cited by 32 publications

(13 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In cases of specific tracers against certain imaging targets (like inflammatory cells) or poor myocardium to background ratio, polar plots cannot be created using these methods. In this respect, it is important to appreciate that some of the most promising applications of cardiac PET/MRI involve the imaging of myocardial inflammation, which currently is either performed using FDG with dietary suppression of myocardial glucose uptake [17] or with specific tracers against inflammatory cells that do not show significant uptake in myocardial cells [18]. In both cases it is not possible to create valid polar plots of the left ventricular tracer uptake using standard software.…”

Section: Discussionmentioning

confidence: 99%

Integrated Assessment of Cardiac PET/MRI: Co-Registered PET and MRI Polar Plots by Mutual MR-Based Segmentation of the Left Ventricular Myocardium

Nensa¹,

Poeppel²,

Tezgah³

et al. 2017

WJCD

Self Cite

View full text Add to dashboard Cite

Background: In the present study, we sought to describe a procedure for the creation of co-registered positron emission tomography (PET) and magnetic resonance imaging (MRI) polar plots of cardiac PET/MRI examinations, validate the resulting plots against available standard methods in patients with myocardial infarction and provide examples that demonstrate the advantage of the novel approach over existing standards. Methods: Co-registered LGE and PET short-axis images were transformed into polar maps based on a radial sampling pattern. LGE was automatically detected using an automated thresholding algorithm (ATA). In 20 PET/MRI examinations in patients with acute myocardial infarction, agreement between manual LGE assessment and the ATA classification was calculated. Also agreement between MRI-segmentation based PET polar plots and standard PET polar plots (created with the Corridor4DM software package) was assessed. Results: No statistically significant difference in infarct sizes between manual and ATA segmentation was found (p = 0.12). Both methods were highly correlated (Pearson's r = 0.96, p < 0.01). Bland-Altman analysis revealed lower and upper limits of agreement of −4.7 g and 3.6 g. Agreement between MRI-segmentation based PET polar plots and standard PET polar plots was very high (mean kappa of 0.91 ± 0.10; p < 0.01 in all cases). In three additional patients with myocardial inflammation, the software successfully created polar plots that demonstrate How to cite this paper: Nensa, F., Poeppel, T.D., Tezgah, E., Heusch, P., Nassenstein, K., Forsting, M., Bockisch, A., Erbel, R. and 92the location and extent of pathologic tracer uptake in the left ventricular myocardium. Conclusion: A straightforward software approach for the creation of co-registered PET and MRI polar plots was described and successfully demonstrated in PET/MRI studies of myocardial infarction and inflammation.

show abstract

Section: Discussionmentioning

confidence: 99%

Integrated Assessment of Cardiac PET/MRI: Co-Registered PET and MRI Polar Plots by Mutual MR-Based Segmentation of the Left Ventricular Myocardium

Nensa¹,

Poeppel²,

Tezgah³

et al. 2017

WJCD

Self Cite

View full text Add to dashboard Cite

show abstract

“…Nensa and colleagues cast the net wide, observing a wide range of cardiac inflammatory conditions; the overall result being that of sufficient myocardial 18 FDG uptake suppression with the use of this strict protocol. 13 It should be noted that this study only included four patients with suspected myocardial transplant rejection, thus opening the door further for assessment of this technique in a larger patient population.…”

Section: Pet and The Post-transplant Populationmentioning

confidence: 99%

Opening the door to noninvasive assessment of cardiac transplant rejection: It’s all in the preparation

Jayadeva

Better

2020

Journal of Nuclear Cardiology

View full text Add to dashboard Cite

“…For 18 F-FDG PET imaging of myocardial inflammation it is important to realise, that healthy myocardium utilises both glucose and free fatty acids, depending on the patient's nutrition and fasting status. To achieve high contrast between inflammatory infiltrates and normal myocardium, it is necessary to suppress myocardial glucose metabolism, which can be obtained by different protocols including prolonged fasting, high-fat low-carbohydrate diet, fatty acid loading, and unfractionated heparin loading [61][62][63]. However, fasting has been identified as one major reason for patient discomfort, potentially contributing to increased cancellation rates during cardiac PET/MRI examinations.…”

Section: Inflammatory Heart Diseasementioning

confidence: 99%

Hybrid cardiac imaging using PET/MRI: a joint position statement by the European Society of Cardiovascular Radiology (ESCR) and the European Association of Nuclear Medicine (EANM)

Nensa

Bamberg

Rischpler

et al. 2018

European J Hybrid Imaging

Self Cite

View full text Add to dashboard Cite

Positron emission tomography (PET) and magnetic resonance imaging (MRI) have both been used for decades in cardiovascular imaging. Since 2010, hybrid PET/MRI using sequential and integrated scanner platforms has been available, with hybrid cardiac PET/MR imaging protocols increasingly incorporated into clinical workflows. Given the range of complementary information provided by each method, the use of hybrid PET/MRI may be justified and beneficial in particular clinical settings for the evaluation of different disease entities. In the present joint position statement, we critically review the role and value of integrated PET/MRI in cardiovascular imaging, provide a technical overview of cardiac PET/MRI and practical advice related to the cardiac PET/MRI workflow, identify cardiovascular applications that can potentially benefit from hybrid PET/MRI, and describe the needs for future development and research. In order to encourage its wide dissemination, this article is freely accessible on the European Radiology and European Journal of Hybrid Imaging web sites. Key Points• Studies and case-reports indicate that PET/MRI is a feasible and robust technology.• Promising fields of application include a variety of cardiac conditions. • Larger studies are required to demonstrate its incremental and cost-effective value.• The translation of novel radiopharmaceuticals and MR-sequences will provide exciting new opportunities.

show abstract

Evaluation of a low-carbohydrate diet-based preparation protocol without fasting for cardiac PET/MR imaging

Abstract: A HFLCPP diet in combination with unfractionated heparin was successfully implemented for cardiac PET/MRI and resulted in a sufficient suppression of myocardial FDG uptake in 84% of patients.

Cited by 32 publications

References 21 publications

Integrated Assessment of Cardiac PET/MRI: Co-Registered PET and MRI Polar Plots by Mutual MR-Based Segmentation of the Left Ventricular Myocardium

Integrated Assessment of Cardiac PET/MRI: Co-Registered PET and MRI Polar Plots by Mutual MR-Based Segmentation of the Left Ventricular Myocardium

Opening the door to noninvasive assessment of cardiac transplant rejection: It’s all in the preparation

Hybrid cardiac imaging using PET/MRI: a joint position statement by the European Society of Cardiovascular Radiology (ESCR) and the European Association of Nuclear Medicine (EANM)

Contact Info

Product

Resources

About