Simultaneous measurements of myocardial glucose metabolism and extracellular volumes with hybrid PET/MRI using concurrent injections of Gd-DTPA and [18F]FDG

J Nucl Cardiol. 2022 Jun;29(3):1304-1314. doi: 10.1007/s12350-020-02486-6. Epub 2021 Jan 27.

Abstract

Background: The aims of this study were to investigate the application of a constant infusion (CI) to mitigate the issue of constantly changing Gd-DTPA contrast levels in a bolus injection for extracellular volume (ECV) measurements by (a) comparing a CI alone to a bolus alone and a bolus followed by CI in healthy myocardium, (b) evaluating the impact of glucose suppression using heparin on ECV.

Methods: Five healthy canine subjects were imaged to compare three different protocols for injecting Gd-DTPA and FDG: bolus alone, CI alone, bolus followed by CI. Suppression of myocardial glucose uptake was induced using a continuous infusion of 20% lipid at a rate of 0.25 mL·min-1·kg-1 as well as 2000 units of intravenous heparin injected 20 minutes prior to FDG/Gd-DTPA injection.

Results: There was no significant effect on ECV measurement when heparin was used for glucose suppression at equilibrium irrespective of infusion protocol). Measurements of ECV in myocardium, regardless of infusion protocol showed no significant difference at all time points (P = 0.21) prior to washout.

Conclusions: The suppression of myocardial uptake of [18F]FDG with heparin did not alter the determination of myocardial ECV though a larger sample size may show differences. Further, the infusion protocol (bolus or constant infusion) had no effect on the calculated ECV.

Keywords: Inflammation; MRI; PET; hybrid imaging; myocardial ischemia and infarction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Contrast Media / metabolism
  • Dogs
  • Fluorodeoxyglucose F18 / metabolism
  • Gadolinium DTPA / metabolism
  • Glucose* / metabolism
  • Heart* / diagnostic imaging
  • Heparin / pharmacology
  • Magnetic Resonance Imaging* / methods
  • Myocardium / metabolism
  • Positron-Emission Tomography* / methods

Substances

  • Contrast Media
  • Fluorodeoxyglucose F18
  • Heparin
  • Glucose
  • Gadolinium DTPA