Cardiovascular

Diabetes is a long-term condition associated with a wide range of complications such as eye, kidney, and cardiovascular diseases, as well as damage to the nerves and vessels. Around 15% develop diabetic foot ulcers resulting from diabetic peripheral neuropathy and arterial insufficiency of the lower extremities. This study aims to demonstrate the value of using 15O-H2O PET/CT in the diagnosis of lower limb ischemia in patients suffering from type 2 diabetes and diabetic foot ulcers. We will compare PET/CT perfusion imaging with hemodynamic measurements. Then, with a follow-up of 2, 5, and 10 years, we will evaluate the prognostic value of PET/CT in wound healing and possible future amputation outcomes. 15O-H2O PET/CT perfusion images provide information on the extent of small vessel disease, which may guide the level of amputation more precisely, thus avoiding unnecessary re-admissions and reoperations. Finally, we will investigate the value of adding a cardiac scan into the workflow in terms of detection of potential unknown cardiac disease in this patient group.

Key research methods

• Test-retest reliability of 15O-H2O PET in lower extremities
• Lower extremity skeletal muscle perfusion measured by 15O-H2O PET
• Myocardial perfusion measured by 15O-H2O PET
• Lower extremity perfusion reserve measured by 15O-H2O PET

Contact Nana Christensen, Biomedical Laboratory Scientist, PhD student

Main supervisor: Lars Poulsen Tolbod, Associate professor, Medical physicist, PhD

Perfusion of the myocardium is compromised in patients with ischemic heart disease. The resulting ischemia causes typical symptoms of chest pain and shortness of breath particularly during exercise where oxygen demand is high. Effective treatment depends on effective diagnostics. To potentially increase availability of effective diagnostics, the project compares the non-invasive diagnostic approaches of PET with 15O-H2O as radiotracer and cardiac MRI with gadolinium contrast by integrated PET/MR. The PET method is widely considered state of the art for perfusion measurements. However, 15O-H2O myocardial perfusion imaging is only available in select PET centers with access to an on-site cyclotron, whereas MRI scanners are ubiquitous in the developed world. If MRI perfusion compares well with 15O-H2O perfusion, more patients will potentially have access to a perfusion study.

Key research methods

• Myocardial perfusion measured by 15O-H2O PET and gadolinium MRI
  
  
• Myocardial scar tissue measured as perfusable tissue index by 15O-H2O PET and late enhancement gadolinium MRI

Contact Simon Madsen, PhD student

Main Supervisor: Lars Christian Gormsen, PhD, Clinical Professor