PMID- 30344958 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20200929 IS - 1949-8462 (Print) IS - 1949-8462 (Electronic) VI - 10 IP - 9 DP - 2018 Sep 26 TI - Accuracy of myocardial viability imaging by cardiac MRI and PET depending on left ventricular function. PG - 110-118 LID - 10.4330/wjc.v10.i9.110 [doi] AB - AIM: To compare myocardial viability assessment accuracy of cardiac magnetic resonance imaging (CMR) compared to [(18)F]-fluorodeoxyglucose (FDG)- positron emission tomography (PET) depending on left ventricular (LV) function. METHODS: One-hundred-five patients with known obstructive coronary artery disease (CAD) and anticipated coronary revascularization were included in the study and examined by CMR on a 1.5T scanner. The CMR protocol consisted of cine-sequences for function analysis and late gadolinium enhancement (LGE) imaging for viability assessment in 8 mm long and contiguous short axis slices. All patients underwent PET using [(18)F]-FDG. Myocardial scars were rated in both CMR and PET on a segmental basis by a 4-point-scale: Score 1 = no LGE, normal FDG-uptake; score 2 = LGE enhancement < 50% of wall thickness, reduced FDG-uptake ( >/= 50% of maximum); score 3 = LGE >/= 50%, reduced FDG-uptake (< 50% of maximum); score 4 = transmural LGE, no FDG-uptake. Segments with score 1 and 2 were categorized "viable", scores 3 and 4 were categorized as "non-viable". Patients were divided into three groups based on LV function as determined by CMR: Ejection fraction (EF), < 30%: n = 45; EF: 30%-50%: n = 44; EF > 50%: n = 16). On a segmental basis, the accuracy of CMR in detecting myocardial scar was compared to PET in the total collective and in the three different patient groups. RESULTS: CMR and PET data of all 105 patients were sufficient for evaluation and 5508 segments were compared in total. In all patients, CMR detected significantly more scars (score 2-4) than PET: 45% vs 40% of all segments (P < 0.0001). In the different LV function groups, CMR found more scar segments than PET in subjects with EF< 30% (55% vs 46%; P < 0.0001) and EF 30%-50% (44% vs 40%; P < 0.005). However, CMR revealed less scars than PET in patients with EF > 50% (15% vs 23%; P < 0.0001). In terms of functional improvement estimation, i.e., expected improvement after revascularization, CMR identified "viable" segments (score 1 and 2) in 72% of segments across all groups, PET in 80% (P < 0.0001). Also in all LV function subgroups, CMR judged less segments viable than PET: EF < 30%, 66% vs 75%; EF = 30%-50%, 72% vs 80%; EF > 50%, 91% vs 94%. CONCLUSION: CMR and PET reveal different diagnostic accuracy in myocardial viability assessment depending on LV function state. CMR, in general, is less optimistic in functional recovery prediction. FAU - Hunold, Peter AU - Hunold P AD - Clinic for Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lubeck, Lubeck 23538, Germany. peterhunold@icloud.com. FAU - Jakob, Heinz AU - Jakob H AD - Department of Thoracic and Cardiovascular Surgery, West German Heart Center, University of Duisburg-Essen, University Hospital Essen, Essen 45122, Germany. FAU - Erbel, Raimund AU - Erbel R AD - Department of Cardiology, West German Heart Center, University of Duisburg-Essen, University Hospital Essen, Essen 45122, Germany. FAU - Barkhausen, Jorg AU - Barkhausen J AD - Clinic for Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lubeck, Lubeck 23538, Germany. FAU - Heilmaier, Christina AU - Heilmaier C AD - Department of Radiology and Nuclear Medicine, Stadtspital Triemli, Zurich 8063, Switzerland. LA - eng PT - Journal Article PL - United States TA - World J Cardiol JT - World journal of cardiology JID - 101537090 PMC - PMC6189071 OTO - NOTNLM OT - Coronary artery disease OT - Magnetic resonance imaging OT - Myocardial infarction OT - Myocardium OT - Positron-emission tomography OT - Ventricular dysfunction COIS- Conflict-of-interest statement: None of the authors states a conflict of interest concerning firms and products reported in this study. EDAT- 2018/10/23 06:00 MHDA- 2018/10/23 06:01 PMCR- 2018/09/26 CRDT- 2018/10/23 06:00 PHST- 2018/03/29 00:00 [received] PHST- 2018/06/28 00:00 [revised] PHST- 2018/08/05 00:00 [accepted] PHST- 2018/10/23 06:00 [entrez] PHST- 2018/10/23 06:00 [pubmed] PHST- 2018/10/23 06:01 [medline] PHST- 2018/09/26 00:00 [pmc-release] AID - 10.4330/wjc.v10.i9.110 [doi] PST - ppublish SO - World J Cardiol. 2018 Sep 26;10(9):110-118. doi: 10.4330/wjc.v10.i9.110.