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Cardio Diabetes Medicine 2017 367

Cardiac MRI vs PET Scan

Dr. G. N. Mahapatra

Senior Consultant & Head, Dept of Nuclear Medicine,
PET-CT & SPECT-CT
Seven Hills Hospital (JCI USA accredited), Mumbai.

Introduction : Clinical Uses in day to day Practice:
CAD is among the major public health issues across Cardiac MRI (CMR) is a non-invasive diagnostic tool
the globe & is still largely perceived as a conse- which can be used for morphology , function, viability
quence of the incremental occlusion of coronary & perfusion assessment in coronary artery disease
arteries through progressive vascular stenosis that (CAD) & other important infiltrative diseases of the
can be diagnosed by coronary angiography & treat- myocardium .
ed by percutaneous or surgical coronary revascular-
ization. Today an unreasonable a large number of Clinical Uses of Cardiac MRI Vs PET Scan in
symptomatic & asymptomatic at risk patients with CAD :
suspected CAD with risk factors such as diabetes
mellitus, hypertension, dyslipidemia, tobacco smok- i)Rest & Stress CMR myocardial perfusion imaging
ing /consuming either through Paan or cigarettes (MPI) Vs PET Stress –Rest MPI.
will undergo coronary angiography . Another subset ii)LGE or dobutamine stress CMR Vs PET F-18, FDG or
of patients having 100% blockage in the major cor- Rb-82 or N-13 Ammonia, radiotracers in the assess-
onary arteries has been also revascularized without ment of myocardial viability.
accessing myocardial viability. Several large ran-
domized trials have emphasized the limitations of Clinical Uses of Cardiac MRI Vs PET Scan in infiltrative
coronary arteriography studies that lead to thera- Cardiac Diseases.
peutic interventions based only on the morphologic i)Cardiac MRI Vs PET Scan in sarcoidosis ,Amyloido-
severity of epicardial coronary stenosis, these trials sis, Tuberculosis.
advocate for additional proof of haemodynamically
significant stress induced reduction in coronary flow 1.Rest & Stress CMR Myocardial Perfusion
before any therapeutic interventions are undertaken. Imaging (MPI) Vs PET Stress-Rest MPI :
At the clinician’s disposal is a large armamentarium
of tests including treadmill stress test, stress MPI, CMR is a non-invasive diagnostic stool that does not
stress ECHO, stress PET, CT coronary angiography & require ionizing radiation & can be used to assess
cardiac magnetic resonance imaging (CMR). Though myocardial perfusion abnormalities using Gadolini-
all are available for the diagnosis & prognostication um based contrast agent in a dose of 0.1 mmol/per
of patients with suspected and documented coronary Kg of body weight at a rate of 5ml/min. This agent
artery disease (CAD) , selecting the “best test” can has very low nephrotoxicity. Immediately after the
be daunting to clinicians. And understanding of the injection of the contrast agent, images for myocar-
patient population, patient pretest probability of CAD dial perfusion study is obtained. After a gap of 10-15
, the risk benefits and limitations of each technology minutes , i.v. Adenosine infusion with 140 mg/Kg/
will enable the medical imaging professional to assist min for period of 3 minute is administered following
clinicians with test selection. which Gadolinium DTPA is injected at a rate of 0.1
mmol/per Kg of body weight at a rate of 5ml/min,
followed by 3 min of adenosine infusion is continued.
Late Gadolinium enhancement (LGE) imaging study

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