TY - GEN
T1 - Direct 4D Patlak 18F-FDG PET/MR for the Multi-Parametric Assessment of active cardiac sarcoidosis
AU - Karakatsanis, Nicolas A.
AU - Trivieri, Maria G.
AU - Abgral, Ronan
AU - Dweck, Marc R.
AU - Robson, Philip M.
AU - Mani, Venkatesh
AU - Padilla, Maria M.
AU - Miller, Marc
AU - Lala, Anuradha
AU - Sanz, Javier
AU - Contreras, Johanna
AU - Narula, Jagat
AU - Fuster, Valentin
AU - Kovacic, Jason C.
AU - Fayad, Zahi A.
N1 - Funding Information:
The authors would like to gratefully acknowledge support by National Institutes of Health NIH/NHLBI R01HL071021 grant.
Funding Information:
Manuscript received May 1st, 2017. This work was supported by NIH/NHLBI R01HL071021 grant. N. A. Karakatsanis is with the Division of Radiopharmaceutical Sciences, Department of Radiology, Weill Cornell Medical College, Cornell University, New York, NY, USA (e-mail: [email protected]) N. A. Karakatsanis, M. G. Trivieri, P. M. Robson, V. Mani and Z. A. Fayad are with the Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA R. Abgral is with the University Hospital of Brest, Brest, France M. R. Dweck is with the University of Edinburgh, Edinburgh, UK M. M. Padilla, is with the Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA M. Miller, A. Lala, J. Sanz, J. Contreras, J. Narula, V. Fuster and J. C. Kovasic are with the Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Publisher Copyright:
© 2017 IEEE.
PY - 2018/11/12
Y1 - 2018/11/12
N2 - Cardiac involvement in sarcoidosis is currently under-diagnosed despite being the leading cause of death amongst sarcoidosis patients. Therefore, accurate and early diagnosis of subclinical but active cardiac sarcoidosis (ACS) is an important clinical goal. The recent advent of hybrid PET/MRI has enabled the multi-parametric and non-invasive evaluation of ACS in the myocardium at a significantly reduced radiation exposure. Although cardiac MRI with late gadolinium enhancement (LGE) may visualize the anatomical pattern of myocardial injury due to ACS, it cannot differentiate between active disease and old chronic scarring. On the other hand, 18FFDG PET standard uptake values (SUVs), which are used to identify regions of increased myocardial inflammation in patients with ACS, may not discriminate ACS-related inflammatory FDG signal, from high non-specific physiological FDG uptake, often leading to false positive ACS interpretation. In this study, we introduce a clinically feasible dynamic 18F-FDG PET/MR cardiac imaging protocol enabling the 4D analysis of the 18FFDG myocardial uptake pattern, coregistered with the LGE MR images. In addition, we employ advanced direct 4D Patlak parametric PET image reconstructions to deliver, beside standard semi-quantitative SUVs, highly quantitative images of the physiological parameters of FDG uptake rate (Ki), obtained directly from the complete 4D PET acquisition data, for enhanced robustness to statistical noise and Ki quantification. We believe that our proposed framework of multi-parametric 4D 18F-FDG PET/MR cardiac imaging may substantially improve ACS diagnosis by i) allowing a more accurate identification of positive ACS patterns in matched myocardium regions across LGE, SUV as well as Ki images and ii) enabling the quantitative Ki-driven differentiation between true- and false-positive ACS indications for enhanced specificity.
AB - Cardiac involvement in sarcoidosis is currently under-diagnosed despite being the leading cause of death amongst sarcoidosis patients. Therefore, accurate and early diagnosis of subclinical but active cardiac sarcoidosis (ACS) is an important clinical goal. The recent advent of hybrid PET/MRI has enabled the multi-parametric and non-invasive evaluation of ACS in the myocardium at a significantly reduced radiation exposure. Although cardiac MRI with late gadolinium enhancement (LGE) may visualize the anatomical pattern of myocardial injury due to ACS, it cannot differentiate between active disease and old chronic scarring. On the other hand, 18FFDG PET standard uptake values (SUVs), which are used to identify regions of increased myocardial inflammation in patients with ACS, may not discriminate ACS-related inflammatory FDG signal, from high non-specific physiological FDG uptake, often leading to false positive ACS interpretation. In this study, we introduce a clinically feasible dynamic 18F-FDG PET/MR cardiac imaging protocol enabling the 4D analysis of the 18FFDG myocardial uptake pattern, coregistered with the LGE MR images. In addition, we employ advanced direct 4D Patlak parametric PET image reconstructions to deliver, beside standard semi-quantitative SUVs, highly quantitative images of the physiological parameters of FDG uptake rate (Ki), obtained directly from the complete 4D PET acquisition data, for enhanced robustness to statistical noise and Ki quantification. We believe that our proposed framework of multi-parametric 4D 18F-FDG PET/MR cardiac imaging may substantially improve ACS diagnosis by i) allowing a more accurate identification of positive ACS patterns in matched myocardium regions across LGE, SUV as well as Ki images and ii) enabling the quantitative Ki-driven differentiation between true- and false-positive ACS indications for enhanced specificity.
UR - http://www.scopus.com/inward/record.url?scp=85058441215&partnerID=8YFLogxK
U2 - 10.1109/NSSMIC.2017.8532794
DO - 10.1109/NSSMIC.2017.8532794
M3 - Conference paper
AN - SCOPUS:85058441215
T3 - 2017 IEEE Nuclear Science Symposium and Medical Imaging Conference, NSS/MIC 2017 - Conference Proceedings
BT - 2017 IEEE Nuclear Science Symposium and Medical Imaging Conference, NSS/MIC 2017 - Conference Proceedings
PB - IEEE, Institute of Electrical and Electronics Engineers
T2 - 2017 IEEE Nuclear Science Symposium and Medical Imaging Conference, NSS/MIC 2017
Y2 - 21 October 2017 through 28 October 2017
ER -