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SNMMI 2014: PET/MR shows promise for detecting coronary artery disease

by Lauren Dubinsky, Senior Reporter | June 09, 2014
Molecular Imaging
PET/MR — the hybrid molecular imaging technique — has been shown to be an effective tool for detecting coronary artery disease (CAD), according to researchers at this year's Society of Nuclear Medicine and Molecular Imaging meeting.

In 2010, heart disease caused one out of every six fatalities in the U.S., according to 2014 data from the American Heart Association. Furthermore, about 620,000 suffered a first heart attack, and 295,000 had a recurrent episode.

When patients are suspected of having CAD, they usually get a stress test called myocardial perfusion imaging (MPI) to determine if arterial ischemia is present and whether there is a risk of myocardial infarction or heart attack. Many of those patients will get a single photon emission computed tomography (SPECT) scan but recently PET/MR has been seen as a potential alternative because it's better at imaging the structures of soft tissues and the physiological function of the heart.
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The study presented at the meeting involved 10 patients with reversible ischemia that was found with SPECT-MPI. They were injected with a radionuclide PET imaging agent called N-13 ammonia, an MR contrast agent called gadolinium and a pharmaceutical that imitates the stress of exercise called Regadenoson.

The researchers optimized the cardiac PET/MR imaging protocol to register areas of reduced perfusions of blood. The study found that PET/MR had 100 percent sensitivity, 80 percent specificity and 100 percent negative predictive value, which compares favorably to SPECT.

The anatomic information with MR and the functional information with PET give a comprehensive view of the heart. "This allows us to predict or rule out coronary artery disease with more certainty, and in some instances, it allows us to detect disease processes such as areas of hibernating heart muscle that would not have been detected using conventional stress testing methods like SPECT," Dr. Jeffrey M.C. Lau, the principal author of the study, said in a statement.

PET/MR can be performed in a shorter amount of time than SPECT and it has a lower radiation dose. In addition, MR can be used to produce a cinematic, multiple-frame sequence of the motion in certain areas of the heart muscle and PET gives quantitative data about blood flow and a visual interpretation of the disease.

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