title: Integrated FDG PET/MR Imaging for the Assessment of Myocardial Salvage in Reperfused Acute Myocardial Infarction.
abstract: OBJECTIVE
  To compare the size of the area with reduced myocardial fluorodeoxygluose (FDG) uptake with the endocardial surface area (ESA) method as a marker for the area at risk in patients with reperfused acute myocardial infarction.
  
  
  METHODS
  The study was approved by the local institutional review board. All patients gave written informed consent prior to their examination. Twenty-five patients (mean age ± standard deviation, 54 years ± 14) underwent prospective cardiac positron emission tomography/magnetic resonance imaging after acute coronary occlusion and interventional reperfusion. On late gadolinium contrast enhancement images, the size of infarction and the area at risk, as determined with ESA, were assessed and compared with the area of reduced FDG uptake. Statistical analysis comprised paired t tests and Mann-Whitney U tests, as well as Pearson r and Spearman ρ for correlations.
  
  
  RESULTS
  In patients with infarcted myocardium and reduced FDG uptake (n = 18), a good correlation between the area of reduced FDG uptake and the area at risk according to ESA was observed (r = .70, P = .001). The area of reduced FDG uptake (31% ± 11 of left ventricular myocardial mass) was larger than the size of the infarct (10% ± 10, P < .0001) and the area at risk according to ESA (17% ± 13, P < .0001). In six patients, no late contrast enhancement was seen, whereas all patients had an area of reduced FDG uptake (29% ± 8) in the perfusion territory of the culprit artery.
  
  
  CONCLUSIONS
  In patients with reperfused acute myocardial infarction, the area of reduced FDG uptake correlates with the area at risk as determined with the ESA method and is localized in the perfusion territory of the culprit artery in the absence of necrosis, although the area of reduced FDG uptake largely overestimates the size of the infarct and the ESA-based area at risk.
authors.affiliation: From the Department of Diagnostic and Interventional Radiology and Neuroradiology (F.N., K.N., M.F., T.S.), Clinic for Nuclear Medicine (T.P., A.B.), Clinic for Cardiology (E.T., A.A.M., R.E.), and Institute for Pathophysiology (G.H.), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany; and Department of Diagnostic and Interventional Radiology, University Hospital Dusseldorf, University of Dusseldorf, Dusseldorf, Germany (P.H.).
authors.forename: Felix
authors.initials: F
authors.lastname: Nensa
authors.affiliation: From the Department of Diagnostic and Interventional Radiology and Neuroradiology (F.N., K.N., M.F., T.S.), Clinic for Nuclear Medicine (T.P., A.B.), Clinic for Cardiology (E.T., A.A.M., R.E.), and Institute for Pathophysiology (G.H.), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany; and Department of Diagnostic and Interventional Radiology, University Hospital Dusseldorf, University of Dusseldorf, Dusseldorf, Germany (P.H.).
authors.forename: Thorsten
authors.initials: T
authors.lastname: Poeppel
authors.affiliation: From the Department of Diagnostic and Interventional Radiology and Neuroradiology (F.N., K.N., M.F., T.S.), Clinic for Nuclear Medicine (T.P., A.B.), Clinic for Cardiology (E.T., A.A.M., R.E.), and Institute for Pathophysiology (G.H.), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany; and Department of Diagnostic and Interventional Radiology, University Hospital Dusseldorf, University of Dusseldorf, Dusseldorf, Germany (P.H.).
authors.forename: Ercan
authors.initials: E
authors.lastname: Tezgah
authors.affiliation: From the Department of Diagnostic and Interventional Radiology and Neuroradiology (F.N., K.N., M.F., T.S.), Clinic for Nuclear Medicine (T.P., A.B.), Clinic for Cardiology (E.T., A.A.M., R.E.), and Institute for Pathophysiology (G.H.), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany; and Department of Diagnostic and Interventional Radiology, University Hospital Dusseldorf, University of Dusseldorf, Dusseldorf, Germany (P.H.).
authors.forename: Philipp
authors.initials: P
authors.lastname: Heusch
authors.affiliation: From the Department of Diagnostic and Interventional Radiology and Neuroradiology (F.N., K.N., M.F., T.S.), Clinic for Nuclear Medicine (T.P., A.B.), Clinic for Cardiology (E.T., A.A.M., R.E.), and Institute for Pathophysiology (G.H.), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany; and Department of Diagnostic and Interventional Radiology, University Hospital Dusseldorf, University of Dusseldorf, Dusseldorf, Germany (P.H.).
authors.forename: Kai
authors.initials: K
authors.lastname: Nassenstein
authors.affiliation: From the Department of Diagnostic and Interventional Radiology and Neuroradiology (F.N., K.N., M.F., T.S.), Clinic for Nuclear Medicine (T.P., A.B.), Clinic for Cardiology (E.T., A.A.M., R.E.), and Institute for Pathophysiology (G.H.), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany; and Department of Diagnostic and Interventional Radiology, University Hospital Dusseldorf, University of Dusseldorf, Dusseldorf, Germany (P.H.).
authors.forename: Amir A
authors.initials: AA
authors.lastname: Mahabadi
authors.affiliation: From the Department of Diagnostic and Interventional Radiology and Neuroradiology (F.N., K.N., M.F., T.S.), Clinic for Nuclear Medicine (T.P., A.B.), Clinic for Cardiology (E.T., A.A.M., R.E.), and Institute for Pathophysiology (G.H.), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany; and Department of Diagnostic and Interventional Radiology, University Hospital Dusseldorf, University of Dusseldorf, Dusseldorf, Germany (P.H.).
authors.forename: Michael
authors.initials: M
authors.lastname: Forsting
authors.affiliation: From the Department of Diagnostic and Interventional Radiology and Neuroradiology (F.N., K.N., M.F., T.S.), Clinic for Nuclear Medicine (T.P., A.B.), Clinic for Cardiology (E.T., A.A.M., R.E.), and Institute for Pathophysiology (G.H.), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany; and Department of Diagnostic and Interventional Radiology, University Hospital Dusseldorf, University of Dusseldorf, Dusseldorf, Germany (P.H.).
authors.forename: Andreas
authors.initials: A
authors.lastname: Bockisch
authors.affiliation: From the Department of Diagnostic and Interventional Radiology and Neuroradiology (F.N., K.N., M.F., T.S.), Clinic for Nuclear Medicine (T.P., A.B.), Clinic for Cardiology (E.T., A.A.M., R.E.), and Institute for Pathophysiology (G.H.), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany; and Department of Diagnostic and Interventional Radiology, University Hospital Dusseldorf, University of Dusseldorf, Dusseldorf, Germany (P.H.).
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
authors.affiliation: From the Department of Diagnostic and Interventional Radiology and Neuroradiology (F.N., K.N., M.F., T.S.), Clinic for Nuclear Medicine (T.P., A.B.), Clinic for Cardiology (E.T., A.A.M., R.E.), and Institute for Pathophysiology (G.H.), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany; and Department of Diagnostic and Interventional Radiology, University Hospital Dusseldorf, University of Dusseldorf, Dusseldorf, Germany (P.H.).
authors.forename: Gerd
authors.initials: G
authors.lastname: Heusch
authors.affiliation: From the Department of Diagnostic and Interventional Radiology and Neuroradiology (F.N., K.N., M.F., T.S.), Clinic for Nuclear Medicine (T.P., A.B.), Clinic for Cardiology (E.T., A.A.M., R.E.), and Institute for Pathophysiology (G.H.), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany; and Department of Diagnostic and Interventional Radiology, University Hospital Dusseldorf, University of Dusseldorf, Dusseldorf, Germany (P.H.).
authors.forename: Thomas
authors.initials: T
authors.lastname: Schlosser
mesh_terms: D000328:Adult; D057791:Cardiac Imaging Techniques; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery*; D015425:Myocardial Reperfusion; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18