Hybrid PET/CT and PET/MRI imaging of vulnerable coronary plaque and myocardial scar tissue in acute myocardial infarction

• BackgroundFollowing an acute coronary syndrome, combined CT and PET with F-18-NaF can identify coronary atherosclerotic plaques that have ruptured or eroded. However, the processes behind F-18-NaF uptake in vulnerable plaques remain unclear. Methods and ResultsTen patients with STEMI were scanned after F-18-NaF injection, for 75minutes in a Siemens PET/MR scanner using delayed enhancement (LGE). They were then scanned in a Siemens PET/CT scanner for 10minutes. Tissue-to-background ratio (TBR) was compared between the culprit lesion in the IRA and remote non-culprit lesions in an effort to independently validate prior studies. Additionally, we performed a proof-of-principle study comparing TBR in scar tissue and remote myocardium using LGE images and PET/MR or PET/CT data. From the 33 coronary lesions detected on PET/CT, TBRs for culprit lesions were higher than for non-culprit lesions (TBR=2.110.45 vs 1.46 +/- 0.48; P<0.001). Interestingly, the TBR measured on the PET/CT was higher for infarcted myocardium than for remote myocardium (TBR=0.81 +/- 0.10 vs 0.71 +/- 0.05; P=0.003). These results were confirmed using the PET/MR data (TBR=0.81 +/- 0.10 for scar, TBR=0.71 +/- 0.06 for healthy myocardium, P=0.03). Conclusions We confirmed the potential of F-18-NaF PET/CT imaging to detect vulnerable coronary lesions. Moreover, we demonstrated proof-of-principle that F-18-NaF concurrently detects myocardial scar tissue.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)

Nyckelord

PET imaging

Infarction

Myocardial

Magnetic resonance imaging

Vulnerable atherosclerotic plaque

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