Integrated FDG PET/MR Imaging for the Assessment of Myocardial Salvage in Reperfused Acute Myocardial Infarction

Abstract

In patients with reperfused acute myocardial infarction, the area of reduced FDG uptake correlates with the area at risk as determined with the ESA method and is localized in the perfusion territory of the culprit artery in the absence of necrosis, although the area of reduced FDG uptake largely overestimates the size of the infarct and the ESA-based area at risk.

Practical guidelines for rigor and reproducibility in preclinical and clinical studies on cardioprotection

“…CMR [60, 315], computed tomography, echocardiography [102, 103], positron emission tomography [318, 372], single-photon emission computed tomography and fluoroscopy have been performed successfully in dogs and pigs. Due to the chest shape, it may be difficult to obtain optimal scanning angles, which may compromise advanced echocardiographic measurements, e.g.…”

Cardiovascular PET/MR: We need evidence, not hype

“…1 However, he failed to comment on several recent PET/MR studies, which appear to show that the area of reduced FDG uptake largely overestimates the size of the infarct as described by LGE after acute myocardial infarction. 15,16 Indeed, these studies seem to suggest that FDG uptake is reduced in reversibly injured myocardium and recovers over time. 17 Schindler cites a small recent PET/MR study by Rischpler and colleagues in 28 patients imaged 5 to 7 days post percutaneous coronary intervention for acute myocardial infarction.…”

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)

“…With 82 Rb the radiation dose is low and the spatial resolution seems to be sufficient for routine applications and has several advantages compared to SPECT-based myocardial perfusion [37,38]. However, current design does not allow an easy workflow for 82 Rb on a PET/MRI system as the generators are not safe to be operated within a strong magnetic field, novel 18 F-labelled perfusion tracers with a 110-min half-life, high first-pass extraction, and nearly linear flow-related uptake were introduced [39] and quantitative assessment of the transmural extension of perfusion defects has been demonstrated [40]. However, these tracers are not yet broadly available.…”