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Cocker MS, Spence JD, Hammond R, deKemp RA, Lum C, Wells G, Bernick J, Hill A, Nagpal S, Stotts G, Alturkustani M, Adeeko A, Yerofeyeva Y, Rayner K, Peterson J, Khan AR, Naidas AC, Garrard L, Yaffe MJ, Leung E, Prato FS, Tardif JC, Beanlands RSB. [18F]-Fluorodeoxyglucose PET/CT imaging as a marker of carotid plaque inflammation: Comparison to immunohistology and relationship to acuity of events. Int J Cardiol 2018; 271:378-386. [PMID: 30007487 DOI: 10.1016/j.ijcard.2018.05.057] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 05/02/2018] [Accepted: 05/17/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND [18F]-fluorodeoxyglucose (18FDG) uptake imaged with positron emission tomography (PET) and computed tomography (CT) may serve as a biomarker of plaque inflammation. This study evaluated the relationship between carotid plaque 18FDG uptake and a) intraplaque expression of macrophage and macrophage-like cellular CD68 immunohistology; b) intraplaque inflammatory burden using leukocyte-sensitive CD45 immunohistology; c) symptomatic patient presentation; d) time from last cerebrovascular event. METHODS 54 patients scheduled for carotid endarterectomy underwent 18FDG PET/CT imaging. Maximum 18FDG uptake (SUVmax) and tissue-to-blood ratio (TBRmax) was measured for carotid plaques. Quantitative immunohistological analysis of macrophage-like cell expression (CD68) and leukocyte content (CD45) was performed. RESULTS 18FDG uptake was related to CD68 macrophage expression (TBRmax: r = 0.51, p < 0.001), and total-plaque leukocyte CD45 expression (TBRmax: r = 0.632, p = 0.009, p < 0.001). 18FDG TBRmax uptake in carotid plaque associated with patient symptoms was greater than asymptomatic plaque (3.58 ± 1.01 vs. 3.13 ± 1.10, p = 0.008). 18FDG uptake differed between an acuity threshold of <90 days and >90 days (SUVmax:3.15 ± 0.87 vs. 2.52 ± 0.45, p = 0.015). CONCLUSIONS In this CAIN cohort, 18FDG uptake imaged with PET/CT serves a surrogate marker of intraplaque inflammatory macrophage, macrophage-like cell and leukocyte burden. 18FDG uptake is greater in plaque associated with patient symptoms and those with recent cerebrovascular events. Future studies are needed to relate 18FDG uptake and disease progression.
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Affiliation(s)
- Myra S Cocker
- Molecular Function and Imaging Program and the National Cardiac PET Centre, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
| | - J David Spence
- Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Ontario, Canada.
| | - Robert Hammond
- Department of Pathology, Western University, London, Ontario, Canada.
| | - Robert A deKemp
- Molecular Function and Imaging Program and the National Cardiac PET Centre, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
| | - Cheemun Lum
- Department of Radiology, University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada.
| | - George Wells
- Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
| | - Jordan Bernick
- Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
| | - Andrew Hill
- Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
| | - Sudhir Nagpal
- Division of Vascular Surgery, Department of Surgery, University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada.
| | - Grant Stotts
- Division of Neurology, Department of Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada.
| | | | - Adebayo Adeeko
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
| | - Yulia Yerofeyeva
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
| | - Katey Rayner
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario, Canada.
| | - Joan Peterson
- Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
| | - Ali R Khan
- Department of Medical Biophysics, Robarts Research Institute, Western University, London, Ontario, Canada.
| | - Ann C Naidas
- Department of Pathology, Western University, London, Ontario, Canada.
| | - Linda Garrard
- Molecular Function and Imaging Program and the National Cardiac PET Centre, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
| | - Martin J Yaffe
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
| | - Eugene Leung
- Division of Nuclear Medicine, Department of Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada.
| | - Frank S Prato
- Lawson Health Research Institute, London, Ontario, Canada.
| | - Jean-Claude Tardif
- Division of Cardiology, Montreal Heart Institute, University of Montreal, Montreal, Quebec, Canada.
| | - Rob S B Beanlands
- Molecular Function and Imaging Program and the National Cardiac PET Centre, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Department of Radiology, University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada; Division of Nuclear Medicine, Department of Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada.
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Cocker MS, Spence JD, Hammond R, Wells G, deKemp RA, Lum C, Adeeko A, Yaffe MJ, Leung E, Hill A, Nagpal S, Stotts G, Alturkustani M, Hammond L, DaSilva J, Hadizad T, Tardif JC, Beanlands RSB. [ 18F]-NaF PET/CT Identifies Active Calcification in Carotid Plaque. JACC Cardiovasc Imaging 2016; 10:486-488. [PMID: 27318719 DOI: 10.1016/j.jcmg.2016.03.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 03/01/2016] [Accepted: 03/10/2016] [Indexed: 10/21/2022]
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Wu V, Chung S, Cocker MS, Flewitt J, Mikami Y, White JA, Friedrich MG, Axel L. Global diastolic function in endurance athletes: three-dimensional volume tracking of the mitral annulus with cine-CMR. J Cardiovasc Magn Reson 2015. [PMCID: PMC4328169 DOI: 10.1186/1532-429x-17-s1-q6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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McArdle B, Dowsley TF, Cocker MS, Ohira H, deKemp RA, DaSilva J, Ruddy TD, Chow BJ, Beanlands RS. Cardiac PET: metabolic and functional imaging of the myocardium. Semin Nucl Med 2014; 43:434-48. [PMID: 24094711 DOI: 10.1053/j.semnuclmed.2013.06.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cardiac PET has evolved over the past 30 years to gain wider acceptance as a valuable modality for a variety of cardiac conditions. Wider availability of scanners as well as changes in reimbursement policies in more recent years has further increased its use. Moreover, with the emergence of novel radionuclides as well as further advances in scanner technology, the use of cardiac PET can be expected to increase further in both clinical practice and the research arena. PET has demonstrated superior diagnostic accuracy for the diagnosis of coronary artery disease in comparison with single-photon emission tomography while it provides robust prognostic value. The addition of absolute flow quantification increases sensitivity for 3-vessel disease as well as providing incremental functional and prognostic information. Metabolic imaging using (18)F-fluorodeoxyglucose can be used to guide revascularization in the setting of heart failure and also to detect active inflammation in conditions such as cardiac sarcoidosis and within atherosclerotic plaque, improving our understanding of the processes that underlie these conditions. However, although the pace of new developments is rapid, there remains a gap in evidence for many of these advances and further studies are required.
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Affiliation(s)
- Brian McArdle
- National Cardiac PET Centre, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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Spence JD, Cocker MS, Tardif JC, Beanlands RS. Abstract 311: CRP is Probably Not Causal in Atherosclerosis. Arterioscler Thromb Vasc Biol 2014. [DOI: 10.1161/atvb.34.suppl_1.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
C-reactive protein (CRP) is thought to predict increased cardiovascular risk. However, the question of a causal relation to atherosclerosis is in doubt. We studied the relation of CRP to carotid total plaque area (TPA) and stenosis, and to plaque inflammation.
Methods:
In 527 patients with measurement of cardiovascular risk factors and CRP, linear regression was used to assess the relation of CRP to total plaque area (TPA) and stenosis. In a subset of patients scheduled for carotid endarterectomy, preoperative PET/CT with 18F- FDG was used to assess plaque inflammation, validated in endarterectomy specimens.
Results:
Mean age (SD) was 63.3 (12.27); 44.4% were female, 12.7% diabetic. 4.4% of patients had no plaque; in the rest it ranged from 1 to 788 mm2; median 102 mm2, interquartile range (IQR) 215 mm2. TPA > 361 mm2 was present in 10% of patients. Internal carotid (ICA) stenosis >= 60% was present in 38.3%; 34 had occlusion of one ICA; 1 had bilateral occlusion. Mean (SD) percent carotid stenosis (sum of right + left ICA) was 69.11 (56.0)%. Median hsCRP was 2.7; IQR 3.7. In stepwise linear multiple regression significant predictors of TPA (R2= 0.367, p< 0.00001) were age, smoking pack-years (pk-yrs), systolic blood pressure (SysBP), antihypertensive medication (BPMed), sex, lipid medication (LipMed) (in order of significance); CRP was excluded with p=0.35. Significant predictors of stenosis (R2 =0.226, p< 0.00001) were age, LipMed, pk-yrs, BPMed, SysBP. CRP was excluded with p=0.963. In 20 endarterectomy specimens, the direct burden of inflammation, as quantified by CD68 immunohistology, correlated with maximum 18FDG uptake (r=0.716, p<0.001). There was no evidence of a correlation between CRP and CD68 (r=0.159, p=0.50), nor with maximum 18FDG uptake (r=0.238, p=0.31). Furthermore, FDG was more strongly correlated with CD68 than CRP (p=0.02.CRP was inversely related to the extent of fibrous tissue (r=0.549, p=0.034).
Conclusion:
CRP was not associated with plaque inflammation, TPA, or stenosis of the carotid arteries. CRP is probably not a causal factor in atherosclerosis.
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Affiliation(s)
- J David Spence
- Stroke Prevention & Atherosclerosis Rsch Cntr, Robarts Rsch Institute, Western Univ, London, Canada
| | - Myra S Cocker
- National Cardiac PET Cntr, Ottawa Heart Institute, Ottawa, Canada
| | | | - Rob S Beanlands
- National Cardiac PET Cntr, Ottawa Heart Institute, Ottawa, Canada
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Cocker MS, Spence J, McArdle B, deKemp R, Lum C, Hammond R, Youssef G, Yerofeyeva Y, Karavardanyan T, Adeeko A, Hill A, Stotts G, Nagpal S, Renaud J, Klein R, Kelly C, Brennan J, Garrard L, Alturkustani M, Hammond L, DaSilva J, Tardif J, Beanlands R. Evidence for Actively Inflamed Bilateral Carotid Plaque in Patients With Advanced Atherosclerosis, Insight From [18F]-Fluorodeoxyglucose Imaging: A Sub-Study of the Canadian Atherosclerosis Imaging Network (CAIN). Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abstract
Non-invasive cardiac imaging is pivotal in the diagnosis and prognosis of patients with stable CAD. Nuclear SPECT, PET, stress echocardiography and more recently cardiac magnetic resonance imaging have been utilized with excellent diagnostic accuracy. However, along with their inherent individual limitations, most modalities detect ischemia but lack the ability to define coronary anatomy or evaluate for subclinical atherosclerosis. A modality that not only accurately diagnoses obstructive CAD and also facilitates early identification of non-obstructive CAD may be of interest because it may allow for earlier aggressive risk factor modification and primary prevention. Cardiac computerized tomographic angiography (CCTA) has the potential to accurately detect or exclude luminal stenosis, as well as identify and quantify subclinical atherosclerosis in the absence if luminal narrowing. However CCTA, being a relatively a new modality, has less supporting evidence when compared to more mature modalities such as SPECT. Therefore, the question that begs to be addressed is whether CCTA can be utilized as a first line test in establishing the diagnosis and prognosis of CAD.
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Affiliation(s)
- Ahmed Aljizeeri
- Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada
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Mc Ardle BA, Leung E, Ohira H, Cocker MS, deKemp RA, DaSilva J, Birnie D, Beanlands RS, Nery PB. The role of F(18)-fluorodeoxyglucose positron emission tomography in guiding diagnosis and management in patients with known or suspected cardiac sarcoidosis. J Nucl Cardiol 2013; 20:297-306. [PMID: 23288545 DOI: 10.1007/s12350-012-9668-9] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 12/09/2012] [Indexed: 11/30/2022]
Abstract
Cardiac sarcoidosis (CS) has gained significant interest in recent years with the emergence of advanced imaging modalities such as MRI and F(18)-fluorodeoxyglucose-positron emission tomography (FDG-PET) as modalities to aid in the diagnosis of this condition. CS remains a difficult condition to diagnose, particularly in cases of isolated cardiac involvement and it can present with a broad spectrum of clinical syndromes. Furthermore, the appropriate management of these patients remains controversial. FDG-PET has a potential role not only in diagnosis of CS but also in directing further therapies, facilitating the decision to start immunosuppression and monitoring the response to it. In this article, we discuss when to consider FDG-PET, outline the current optimal patient preparation and scanning protocols and then, using case examples, discuss the use of FDG-PET in follow-up of patients with known or suspected CS. We also outline how PET can influence management decisions in these patients.
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Affiliation(s)
- B A Mc Ardle
- Division of Cardiology, Department of Medicine, Arrhythmia Service, University of Ottawa Heart Institute, Ottawa, ON, Canada
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Affiliation(s)
- Hiroshi Ohira
- National Cardiac PET Centre, in the Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute
| | - Brian Mc Ardle
- National Cardiac PET Centre, in the Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute
| | - Myra S. Cocker
- National Cardiac PET Centre, in the Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute
| | - Robert A. deKemp
- National Cardiac PET Centre, in the Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute
| | - Jean N. DaSilva
- National Cardiac PET Centre, in the Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute
| | - Rob S. Beanlands
- National Cardiac PET Centre, in the Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute
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Cocker MS, Mc Ardle B, Spence JD, Lum C, Hammond RR, Ongaro DC, McDonald MA, deKemp RA, Tardif JC, Beanlands RSB. Imaging atherosclerosis with hybrid [18F]fluorodeoxyglucose positron emission tomography/computed tomography imaging: what Leonardo da Vinci could not see. J Nucl Cardiol 2012; 19:1211-25. [PMID: 23073913 PMCID: PMC3510422 DOI: 10.1007/s12350-012-9631-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Prodigious efforts and landmark discoveries have led toward significant advances in our understanding of atherosclerosis. Despite significant efforts, atherosclerosis continues globally to be a leading cause of mortality and reduced quality of life. With surges in the prevalence of obesity and diabetes, atherosclerosis is expected to have an even more pronounced impact upon the global burden of disease. It is imperative to develop strategies for the early detection of disease. Positron emission tomography (PET) imaging utilizing [(18)F]fluorodeoxyglucose (FDG) may provide a non-invasive means of characterizing inflammatory activity within atherosclerotic plaque, thus serving as a surrogate biomarker for detecting vulnerable plaque. The aim of this review is to explore the rationale for performing FDG imaging, provide an overview into the mechanism of action, and summarize findings from the early application of FDG PET imaging in the clinical setting to evaluate vascular disease. Alternative imaging biomarkers and approaches are briefly discussed.
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Affiliation(s)
- Myra S. Cocker
- Molecular Function and Imaging Program, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7 Canada
| | - Brian Mc Ardle
- Molecular Function and Imaging Program, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7 Canada
| | - J. David Spence
- Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, University of Western Ontario, 1400 Western Road, London, ON Canada
| | - Cheemun Lum
- Interventional & Diagnostic Neuroradiology, Department of Radiology, The Ottawa
Hospital, University of Ottawa, Civic Campus, Diagnostic Imaging, K1Y 4E9 Ottawa, ON Canada
| | - Robert R. Hammond
- Departments of Pathology and Clinical Neurological Sciences, London Health Sciences Centre and University of Western Ontario, 339 Windermere Road, N6A 5A5 London, ON Canada
| | - Deidre C. Ongaro
- Molecular Function and Imaging Program, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7 Canada
| | - Matthew A. McDonald
- Molecular Function and Imaging Program, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7 Canada
| | - Robert A. deKemp
- Molecular Function and Imaging Program, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7 Canada
| | | | - Rob S. B. Beanlands
- Molecular Function and Imaging Program, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7 Canada
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Cocker MS, Shea SM, Strohm O, Green J, Abdel-Aty H, Friedrich MG. A new approach towards improved visualization of myocardial edema using T2-weighted imaging: a cardiovascular magnetic resonance (CMR) study. J Magn Reson Imaging 2012; 34:286-92. [PMID: 21780224 DOI: 10.1002/jmri.22622] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To compare T2-weighted cardiovascular magnetic resonance (CMR) imaging with AASPIR (asymmetric adiabatic spectral inversion recovery) and STIR (short T1 inversion recovery) for myocardial signal intensity, image quality, and fat suppression. MATERIALS AND METHODS Forty consecutive patients (47 ± 16 years old) referred by cardiologists for CMR-based myocardial tissue characterization were scanned with both STIR and AASPIR T2-weighted imaging approaches. Signal intensity of left ventricular myocardium was normalized to a region of interest generating a signal-to-noise ratio (SNR). In six patients with regional edema on STIR the contrast-to-noise ratio (CNR) was assessed. Two independent observers used a scoring system to evaluate image quality and artifact suppression. Six healthy volunteers (three males, 32 ± 7 years) were recruited to compare fat suppression between AASPIR and STIR. RESULTS SNR of AASPIR was greater than STIR for basal (128 ± 44 vs. 83 ± 40, P < 0.001), mid- (144 ± 65 vs. 96 ± 39, P < 0.01), and apical (145 ± 59 vs. 105 ± 35, P < 0.05) myocardium. Improved image quality and greater suppression of artifacts was demonstrated with AASPIR. In patients with regional edema, CNR increased by 49% with AASPIR, while SNR of pericardial fat did not differ (44 ± 39 vs. 33 ± 30, P > 0.05). CONCLUSION Our findings support the implementation of an AASPIR-based approach for T2-weighted imaging due to improved pericardial fat suppression, image quality, and artifact suppression with greater CNR and SNR.
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Affiliation(s)
- Myra S Cocker
- Stephenson CMR Centre at the Libin Cardiovascular Institute, University of Calgary, Department of Cardiac Sciences, Foothills Hospital, Calgary, Alberta, Canada
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Strohm O, Cocker MS, Fung TS, Kary S, Childs H, Friedrich MG. Evidence of an increased incidence of myocardial inflammation associated with reduced ventricular function in clinically suspected idiopathic dilated cardiomyopathy - a cardiovascular magnetic resonance study. J Cardiovasc Magn Reson 2011. [PMCID: PMC3106587 DOI: 10.1186/1532-429x-13-s1-p266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Cocker MS, Haykowsky MJ, Friedrich MG. Development of myocardial edema following acute bouts of intense physical exertion in healthy active men: a Cardiovascular Magnetic Resonance (CMR) study. J Cardiovasc Magn Reson 2011. [PMCID: PMC3106686 DOI: 10.1186/1532-429x-13-s1-o111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Mikami Y, Ferreira VM, Hare J, Kumar A, Cocker MS, Strohm O, Friedrich MG. Relationship between edema and wall thickness in acute myocardial infarction. J Cardiovasc Magn Reson 2010. [DOI: 10.1186/1532-429x-12-s1-p156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Cocker MS, Strohm O, Smith DJ, Butler C, Belenkie I, Meeuwisse W, Friedrich MG. Myocardial fibrosis is a prevalent finding in elite high-endurance athletes. J Cardiovasc Magn Reson 2009. [PMCID: PMC7860850 DOI: 10.1186/1532-429x-11-s1-o68] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Cocker MS, Strohm O, Smith DJ, Butler C, Belenkie I, Meeuwisse W, Friedrich MG. Sub-clinical systolic dysfunction with persistent myocardial edema and inflammation in elite high-endurance athletes with common colds: a cardiovascular magnetic resonance study. J Cardiovasc Magn Reson 2009. [PMCID: PMC7852003 DOI: 10.1186/1532-429x-11-s1-o3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Cocker MS, Abdel-Aty H, Alakija P, Strohm O, Friedrich MG. Images in cardiology. Cardiac magnetic resonance imaging in Löffler's endocarditis. Can J Cardiol 2008; 24:e89-90. [PMID: 18987768 DOI: 10.1016/s0828-282x(08)70203-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Myra S Cocker
- Stephenson Cardiovascular MR Centre, Foothills Medical Centre, Department of Cardiac Sciences, University of Calgary, Alberta
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Cocker MS, Strohm O, Green JD, Shea SM, Abdel-Aty H, Friedrich MG. 1142 A new approach towards improved visualization of myocardial edema using T2-weighted imaging. J Cardiovasc Magn Reson 2008. [DOI: 10.1186/1532-429x-10-s1-a267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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