Direct comparison of fluorine-18-FDG SPECT, fluorine-18-FDG PET and rest thallium-201 SPECT for detection of myocardial viability.
Twenty consecutive patients were evaluated for presumptive myocardial viability using rest TI-SPECT, FDG-PET and FDG-SPECT. The FDG studies were performed after rest TI-SPECT to guide intervention or medical management.


METHODS
Twenty patients with proven coronary artery disease, either known or suspected to have previous myocardial infarction and persistent perfusion defects shown by rest reinjection TI-SPECT, underwent FDG-PET and subsequent FDG-SPECT with a three-detector SPECT camera. FDG-PET and SPECT images were compared by five observers to determine if any fixed thallium segments were visualized by either FDG imaging method.


RESULTS
Thirteen of 60 fixed segments were shown probably viable by FDG-SPECT (8 of 20 patients) and 14 of 60 by FDG PET (7 of 20 patients). Two patients had fixed thallium segments found probably viable with FDG by SPECT alone and one by PET alone.


CONCLUSIONS
FDG is shown to provide additional information about myocardial viability. Both SPECT, using a three-detector camera, and PET with a specialized instrument are equally effective for imaging FDG in this application.
Burt
R W
RW
Department of Radiology, Richard L. Roudebush Veteran's Affairs Medical Center, Indianapolis, Indiana.
Perkins
O W
OW
Oppenheim
B E
BE
Schauwecker
D S
DS
Stein
L
L
Wellman
H N
HN
Witt
R M
RM
D003327:Coronary Disease / Q000000981:diagnostic imaging*; D003847:Deoxyglucose / Q000031:analogs & derivatives; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D011446:Prospective Studies; D013794:Thallium Radioisotopes; D014055:Tomography, Emission-Computed; D015899:Tomography, Emission-Computed, Single-Photon
D005462:Fluorine Radioisotopes; D013794:Thallium Radioisotopes; D019788:Fluorodeoxyglucose F18; D003847:Deoxyglucose