PMID- 28430739 OWN - NLM STAT- MEDLINE DCOM- 20171226 LR - 20171226 IS - 1473-5628 (Electronic) IS - 0143-3636 (Linking) VI - 38 IP - 6 DP - 2017 Jun TI - Downstream indication to revascularization following hybrid cardiac PET/MRI: preliminary results. PG - 515-522 LID - 10.1097/MNM.0000000000000680 [doi] AB - BACKGROUND: Hybrid PET/MRI allows the acquisition of both fluorine-18-fluorodeoxyglucose (F-FDG) PET and cardiac magnetic resonance (CMR) during one session. Whether this will result in different referral to coronary revascularization (CR) is unknown. We compared this new hybrid method with all-nuclear/all-CMR methods in the assessment of viable myocardium and in downstream referral to CR. PATIENTS AND METHODS: Overall, 12 patients with rest perfusion defects on a single photon emission computed tomography (SPECT) were recruited for cardiac viability assessment using a PET/MRI device. Perfusion (SPECT and CMR), metabolism, late gadolinium enhancement (LGE), and contractility were compared using a 20-segments bull's eye for agreement. The patterns of ischemia/viability were compared between all-nuclear, all-CMR, and hybrid methods. Downstream CR was proposed after correlating findings to coronary angiography. RESULTS: The SPECT and CMR perfusion denoted poor agreement [agreement rate (AR): 60%; kappa: 0.191, P<0.004]. The added PET metabolism concurred in reclassifying 19.2% of segments with intermediate or unassessable LGE using the hybrid method. Overall, the all-CMR method showed better agreement with the hybrid method than the all-nuclear method for findings of normal (AR: 100%, kappa: 1.00 vs. 65.8% %; kappa: 0.347, respectively; P<0.001), scar (AR: 85%; kappa: 0.675 vs. 80.8%; kappa: 0.596, respectively; P<0.001), and ischemic segments (AR: 95.8%; kappa: 0.881 vs. 75.8%; kappa: 0.168, respectively; P<0.001). Downstream CR was proposed in four, 11, and 12 vessels by the all-nuclear, all-CMR, or hybrid methods, respectively. CONCLUSION: Compared with all-CMR, the hybrid method allowed the reclassification of 19.2% segments. Using CMR perfusion instead of SPECT perfusion had a significant impact on downstream target vessel revascularization. FAU - Priamo, Julien AU - Priamo J AD - Divisions of aInternal Medicine bCardiology cNuclear Medicine, University Hospitals Geneva, Geneva, Switzerland. FAU - Adamopoulos, Dionysos AU - Adamopoulos D FAU - Rager, Oliver AU - Rager O FAU - Frei, Angela AU - Frei A FAU - Noble, Stephane AU - Noble S FAU - Carballo, David AU - Carballo D FAU - Ratib, Osman AU - Ratib O FAU - Nkoulou, Rene AU - Nkoulou R LA - eng PT - Journal Article PL - England TA - Nucl Med Commun JT - Nuclear medicine communications JID - 8201017 RN - 0Z5B2CJX4D (Fluorodeoxyglucose F18) SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Female MH - Fluorodeoxyglucose F18 MH - Heart/*diagnostic imaging MH - Humans MH - *Magnetic Resonance Imaging MH - Male MH - Middle Aged MH - *Multimodal Imaging MH - Myocardial Perfusion Imaging MH - *Myocardial Revascularization MH - *Positron-Emission Tomography MH - Tissue Survival EDAT- 2017/04/22 06:00 MHDA- 2017/12/27 06:00 CRDT- 2017/04/22 06:00 PHST- 2017/04/22 06:00 [pubmed] PHST- 2017/12/27 06:00 [medline] PHST- 2017/04/22 06:00 [entrez] AID - 10.1097/MNM.0000000000000680 [doi] PST - ppublish SO - Nucl Med Commun. 2017 Jun;38(6):515-522. doi: 10.1097/MNM.0000000000000680.