Quantitative Simultaneous Cardiac PET-MR

描述（由申请人提供）：对已知或疑似缺血性心肌病患者进行评价和最佳管理需要评估心肌缺血的程度和范围以及心肌梗死和瘢痕的范围。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机运动引起的退化的限制。另一方面，心脏MR（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的程度。它还可以识别与各种非缺血性心肌病相关的临床重要的晚期钆增强模式，并提供对整体和局部室壁运动异常的评估。此外，CMR可用于估计给定梗死的透壁程度，其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心肌。然而，CMR对缺血严重程度的量化，特别是当同时存在瘢痕时，还不太确定。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提供一个全面的评估，存活心肌以及评估非透壁性梗死患者的残余缺血。我们将开发一种新的列表模式PET重建框架，该框架将MR测量的心脏和呼吸运动纳入PET发射系统矩阵以及时间相关的衰减图和位置相关的点扩散函数。

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.