Combined study with I-123 fatty acid and thallium-201 to assess ischemic myocardium: comparison with thallium redistribution and glucose metabolism.
To assess the clinical value of combined SPECT imaging with I-123-15-(p-iodophenyl)-3-methyl pentadecanoic acid (BMIPP) and thallium-201 (Tl), the findings were compared with those obtained in a stress Tl study and positron emission tomography (PET) with fluorine-18-fluorodeoxyglucose (FDG) in 22 patients with myocardial infarction. In 20 patients who underwent a stress Tl study, among 75 hypoperfused segments, 27 segments exhibited less BMIPP uptake than Tl (discordant segments), and the remaining 48 segments showed a similar decrease in BMIPP uptake (concordant segments). Twenty-two of 27 discordant segments (81%) exhibited redistribution on stress Tl study. On the other hand, only one of the 48 concordant segments had redistribution (p < 0.001). In 10 patients who underwent a FDG PET study, among 33 hypoperfused segments, seven segments were discordant segments, and the remaining 25 segments were concordant segments. Seven of the eight discordant segments (88%) demonstrated an increase in FDG uptake. In contrast, only five of 25 concordant segments (20%) showed increase in FDG uptake (p < 0.01). Thus, the segments showing discordant BMIPP uptake are considered to be ischemic but viable myocardium. We conclude that combined imaging with BMIPP and Tl is a useful mean for evaluating tissue viability in patients with coronary artery disease, but it may underestimate the extent of tissue viability, compared with FDG PET imaging.
Kawamoto
M
M
Department of Nuclear Medicine, Kyoto University Faculty of Medicine, Japan.
Tamaki
N
N
Yonekura
Y
Y
Tadamura
E
E
Fujibayashi
Y
Y
Magata
Y
Y
Nohara
R
R
Sasayama
S
S
Ikekubo
K
K
Kato
H
H
D000328:Adult; D000368:Aged; D003847:Deoxyglucose / Q000031:analogs & derivatives / Q000493:pharmacokinetics; D005080:Exercise Test; D005227:Fatty Acids; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007462:Iodobenzenes / Q000493:pharmacokinetics; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000378:metabolism; D013794:Thallium Radioisotopes / Q000493:pharmacokinetics; D014055:Tomography, Emission-Computed; D015899:Tomography, Emission-Computed, Single-Photon
D005227:Fatty Acids; D007462:Iodobenzenes; D013794:Thallium Radioisotopes; C049338:iodofiltic acid; D019788:Fluorodeoxyglucose F18; D003847:Deoxyglucose; D005947:Glucose