Quantitative Simultaneous Cardiac PET-MR

描述(由申请人提供)：对已知或可疑的缺血性心肌病患者的评估和最佳治疗需要评估心肌缺血的程度和程度，以及心肌梗死和疤痕的程度。虽然PET心肌灌注成像提供了最可靠的方法来评估缺血的存在和严重程度，但目前它受到心脏和呼吸器运动引起的退化的限制。另一方面，心脏磁共振(CMR)目前提供了最准确的方法来检测心肌瘢痕的存在和评估其程度。它还可以识别与各种非缺血性心肌病相关的临床上重要的晚期Gd增强模式，并提供对整体和局部室壁运动异常的评估。此外，CMR可以用来估计给定的心肌梗死的跨壁范围，这与冠状动脉血运重建后恢复的可能性直接相关，从而准确地识别存活的心肌。然而，在CMR中，对缺血严重程度的量化，特别是当同时存在瘢痕时，较少确定。为了利用每种技术的固有优势并解决这些模式的根本局限性，我们建议使用同步PET-MR来提供对存活心肌的全面评估以及对非穿透性心肌梗死患者残余缺血的评估。我们将开发一种新的列表模式PET重建框架，将MR测量的心脏和呼吸运动结合到PET发射系统矩阵中，以及随时间变化的衰减图和随位置变化的点扩散函数。

DESCRIPTION (provided by applicant): Evaluation and optimal management of patients with known or suspected ischemic cardiomyopathy requires an assessment of the magnitude and extent of myocardial ischemia as well as the extent of myocardial infarction and scar. While PET myocardial perfusion imaging offers the most robust method to evaluate the presence and severity of ischemia, it is currently limited by the degradation due to both cardiac and respirator motion. On the other hand, cardiac MR (CMR) currently offers the most accurate method to detect the presence and assess the extent of myocardial scar. It can also identify clinically important late gadolinium enhancement patterns associated with various non-ischemic cardiomyopathies and provides an assessment of global and regional wall motion abnormalities. Furthermore, CMR can be used to estimate the transmural extent of a given infarct, which directly correlates with the likelihood of recovery post coronary revascularization, and thus accurately identifies viable myocardium. However, quantification of the severity of ischemia, particularly when concomitant scar is also present, is less established with CMR. In order to take advantage of the inherent strengths of each technique and resolve fundamental limitations of these modalities, we propose to use simultaneous PET-MR to provide a comprehensive assessment of viable myocardium as well as an assessment of residual ischemia in patients with non-transmural infarctions. We will develop a novel list-mode PET reconstruction framework that incorporates cardiac and respiratory motion measured by MR into PET emission system matrix as well as the time-dependent attenuation map and the position dependent point spread function.