Routine 18F-2-deoxy-2-fluoro-D-glucose (18F-FDG) myocardial tomography using a normal large field of view gamma-camera.
There is a recent need to study glucose metabolism of the heart in ischemic, as well as in "hibernating or stunned" myocardium, and compare it with that in perfusion studies. In non-positron emission tomography centers, positron imaging is possible with a standard Anger-type camera if proper collimation and adequate shielding of the camera crystal can be achieved. For the study with fast-decaying isotopes, seven-pinhole tomography (7PHT), a limited-angle method designed for transaxial tomography of the left ventricle using a nonrotating camera, is well suited, because projections are acquired simultaneously. Individual adjustment (patient supine) of the camera's view axis (CAx) with the left ventricular axis (LVAx) gives excellent results: sensitivity for CHD 82%, specificity 72% in a prospective 201TI study (48 patients, x-ray coronarography as reference). Good alignment of CAx with LVAx is also achieved with the patient prone in LAO in a hammock above the camera surface. In this setting additional lead shielding of the camera is possible using a table reinforced with 5 cm of lead with a central hole for the 7PH-collimator, which has a special lead inlay. This allows utilization of the 511 KeV emitter 18F-FDG, which with a half-life of 109 minutes, can be transported a reasonable distance from the production site. System sensitivity and resolution for 18F was found comparable to 201Tl, 99mTc, and 123I using a phantom. First clinical examinations after 201Tl stress/redistribution studies showed increased 18F-FDG uptake in ischemic heart segments, as well as in "hibernating" nonperfused or "stunned" myocardium.
Höflin
F
F
University of Berne, Dept. of Nuclear Medicine, Inselspital, Switzerland.
Ledermann
H
H
Noelpp
U
U
Weinreich
R
R
Rösler
H
H
D003837:Deoxy Sugars; D003847:Deoxyglucose / Q000031:analogs & derivatives; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D015902:Gamma Cameras; D005947:Glucose / Q000378:metabolism; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D009206:Myocardium / Q000378:metabolism; D015899:Tomography, Emission-Computed, Single-Photon / Q000295:instrumentation / Q000379:methods
D003837:Deoxy Sugars; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D003847:Deoxyglucose; D005947:Glucose