Comparison of 31P-MR-spectroscopy and 23Na-MR-tomography versus positron emission tomography for assessment of myocardial viability
Project management at the University of Würzburg:
Assessment of myocardial viablility is crucial for the correct treatment in coronary artery disease (CAD). Currently, positron emission tomography (PET) is the gold standard for detection of myocardial viability. Available at several sites in Germany, PET is currently rather expensive and uses ionizing radiation. Therefore, non-invasive as well as cheaper techniques for assessment of myocardial viability are missing. Recently, new, non-invasive cardiac MR-techniques have been presented for analysis of myocardial morphology, function and metabolism. MR scanners can be found at various sites all over Germany, the costs for MR examinations are acceptable. Nevertheless, the exact clinical relevance of the new MR-techniques has not been assessed. Reasons are demanding technical problems which have to be solved as well as the lack of studies, comparing these new techniques with established techniques. Aim of this project is to assess the value of 31P-MR-spectroscopy (MRS) and 23Na-MR-imaging (MRI) for detection of myocardial viability in comparison with PET. Both techniques may contribute to the solution of one of the most urgent problems of current cardiologic diagnosis, that is the assessment of myocardial viability. Quantitative 31P-MRS techniques should allow an improved analysis of energetic derangements in higher spatial resolution than currently available, using acquisition-weighted CSI (AW-CSI) in combination with SLOOP. Besides energetics, cellular hemeostasis is essential for myocardial viability. 23Na-MRI allows for non-invasive insight into these processes. Here, new quantitative techniques have to be developed. Both MR-techniques are characterized by their non-invasivity. Lacking ionizing radiation, arterial catherization and use of contrast agents containing iodine, both methods can be applied in an outpatient department. These factors reduce the costs of MR examinations compared to other established methods. The F12-project is focussed on new techniques for assessment of myocardial viability, allowing a better understanding of the complex interplay of vascular, energetic and functional alterations in CAD. This links the new F12-project with one of the main interests of the IZKF, the analysis of vasculopathic alterations.
Projekt period: from 05.2002 to 04.2004