Myocardial first-pass perfusion: influence of spatial resolution and heart rate on the dark rim artifact.

Myocardial perfusion images can be affected by the dark rim artifact. This study aimed to evaluate the effects of the spatial resolution and heart rate on the transmural extent of the artifact. Six pigs under anesthesia were scanned at 1.5T using an echo-planar imaging/fast gradient echo sequence with a nonselective saturation preparation pulse. Three short-axis slices were acquired every heart beat during the first pass of a contrast agent bolus. Two different in-plane spatial resolutions (2.65 and 3.75 mm) and two different heart rates (normal and tachycardia) were used, generating a set of four perfusion scans. The percentage drop of signal in the subendocardium compared to the epicardium and the transmural extent of the artifact were extracted. Additionally, the signal-to-noise and the contrast-to-noise ratios were evaluated. The signal drop as well as the width of the dark rim artifact increased with decreased spatial resolution and with increased heart rates. No significant slice-to-slice variability was detected for signal drop and width of the rim within the four considered groups. signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) ratios decreased with increasing spatial resolution. In conclusion, low spatial and temporal resolution could be correlated with increased extent of the dark-rim artifact and with lower SNR and CNR.

Detection of colorectal polyps in humans using an intravenously administered fluorescent peptide targeted against c-Met.

Colon cancer prevention currently relies on colonoscopy using white light to detect and remove polyps, but small and flat polyps are difficult to detect and frequently missed when using this technique. Fluorescence colonoscopy combined with a fluorescent probe specific for a polyp biomarker may improve polyp detection. Here we describe GE-137, a water-soluble probe consisting of a 26-amino acid cyclic peptide that binds the human tyrosine kinase c-Met conjugated to a fluorescent cyanine dye. Intravenous administration of GE-137 leads to its accumulation specifically in c-Met-expressing tumors in mice, and it is safe and well tolerated in humans. Fluorescence colonoscopy in patients receiving intravenous GE-137 enabled visualization of all neoplastic polyps that were visible with white light (38), as well as an additional nine polyps that were not visible with white light. This first-in-human pilot study shows that molecular imaging using an intravenous fluorescent agent specific for c-Met is feasible and safe, and that it may enable the detection of polyps missed by other techniques.

Perfusion abnormalities in pulmonary embolism studied with perfusion MRI and ventilation-perfusion scintigraphy: an intra-modality and inter-modality agreement study.

PURPOSE: To compare perfusion magnetic resonance imaging (MRI) and ventilation-perfusion scintigraphy (V-P scan) in the study of perfusion abnormalities in pulmonary embolism (PE) and to compare the PE results to the findings previously reported for pneumonia and chronic obstructive pulmonary disease (COPD), in terms of perfusion abnormalities. MATERIALS AND METHODS: Dynamic contrast-enhanced MR images and V-P scans of 20 patients with PE, 11 patients with acute pneumonia, and 13 patients with exacerbation of COPD were studied. Five categories of perfusion abnormalities within each imaging modality were defined. Intra- and inter-modality agreement (kappa values) in the evaluation of perfusion abnormalities were calculated, based on the two observers of each imaging modality (all blinded to each other and true diagnosis). Finally, three categories of perfusion MRI diagnosis (PE, pneumonia, and COPD) were also defined and the inter-observer agreement (kappa value) was calculated. RESULTS: For PE, the intra-modality agreement (kappa value) in the evaluation of perfusion abnormalities was 0.77 for MRI and 0.65 for V-P scan. The inter-modality agreement varied from 0.52 to 0.57, respectively, and was observer-dependent. For the pooled group of PE, pneumonia, and COPD, the intra-modality agreement of perfusion abnormalities was 0.76 for MRI and 0.65 for V-P scan, and the inter-modality agreement varied from 0.51 to 0.56. The kappa value for inter-observer agreement for MRI diagnosis was 0.92. CONCLUSION: Evaluation of perfusion abnormalities in PE, pneumonia, and COPD using perfusion MRI and V-P scan showed a high intra-modality agreement that was higher than the inter-modality agreement. Further studies are now needed in patients presenting with possible PE to evaluate the sensitivity and specificity of the method.