Motion-Corrected Whole-Heart PET-MR for Simultaneous Visualisation of Coronary Artery Integrity and Myocardial Viability

This small validation study tested a respiratory motion-corrected PET-MR framework for simultaneously imaging coronary artery anatomy and myocardial viability — using PET for perfusion and late gadolinium enhancement MRI for scar assessment, with motion correction applied to both modalities simultaneously.

In 14 patients with chronic total occlusion, motion correction improved vessel length and sharpness in coronary MR angiography and enhanced PET signal delineation, showing better agreement with late gadolinium enhancement MRI and invasive angiography.

Simultaneous coronary PET-MR is an ambitious technical goal: it promises a single examination that could replace separate nuclear perfusion studies and MRI viability assessments. This study demonstrates feasibility with good motion correction. The sample size of 14 is too small for clinical validation, and the technique’s complex acquisition is not yet compatible with routine clinical workflows.

We rate the evidence limited. An initial clinical validation of a sophisticated dual-modality imaging approach; larger studies in more diverse patient populations are needed before this framework can influence clinical practice.