Sequential PET/diffusion-weighted imaging in the evaluation of myocardial perfusion and viability in coronary artery disease: a preliminary study. Issue 1 (January 2020)

• Record Type: Journal Article
• Authors: Ling, Xueying; Chen, Jianxin; Shang, Jingjie; Tang, Yongjin; Cheng, Yong; Xu, Hao
• Is Part Of: Nuclear medicine communications. Volume 41:Issue 1(2020)
• Publication Date: 2020-01
• Subjects: diffusion-weighted imaging -- myocardium -- perfusion -- PET; Nuclear medicine -- Periodicals; 616.07575
• DOI: 10.1097/MNM.0000000000001109
• Languages: English
• ISSNs: 0143-3636

Abstract

Abstract : 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 99m methoxyisobutylisonitrile ( 99m 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 99m 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.