Comparison of myocardial uptake of fluorine-18-fluorodeoxyglucose imaged with PET and SPECT in dyssynergic myocardium.
PET with 18F-fluorodeoxyglucose (FDG) can detect viable myocardium and predict functional recovery after revascularization. The use of PET for clinical routine, however, is limited. Recently, imaging FDG with SPECT was proposed. The aim of this study was to compare the diagnostic value of FDG-PET and FDG-SPECT in the detection of viable myocardium in segments with abnormal wall motion.


METHODS
Twenty patients with previous myocardial infarction were studied. All underwent FDG-PET and FDG-SPECT during hyperinsulinemic glucose clamping. Regional perfusion was assessed with 13N-ammonia PET and early resting 201TI- SPECT. Regional wall motion was assessed with two-dimensional echocardiography. The agreement between FDG/13N-ammonia PET and FDG/201TISPECT to detect viability in dyssynergic myocardium was 76%. On a patient basis, PET and SPECT yielded comparable results in 17 of 20 patients. In a subgroup of patients with LVEF < or = 35% (n = 12), all PET and SPECT viability data were identical.


CONCLUSIONS
This study shows a good correlation between the detection of viability in dyssynergic myocardium with FDG/13N-ammonia PET and FDG/201TI SPECT, both on a segmental and patient basis.
Bax
J J
JJ
Department of Cardiology, Free University Hospital Amsterdam, The Netherlands.
Visser
F C
FC
Blanksma
P K
PK
Veening
M A
MA
Tan
E S
ES
Willemsen
T M
TM
van Lingen
A
A
Teule
G J
GJ
Vaalburg
W
W
Lie
K I
KI
Visser
C A
CA
D000641:Ammonia; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003847:Deoxyglucose / Q000031:analogs & derivatives*; D004452:Echocardiography; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D015309:Glucose Clamp Technique; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology; D009590:Nitrogen Radioisotopes; D013794:Thallium Radioisotopes; D014055:Tomography, Emission-Computed; D015899:Tomography, Emission-Computed, Single-Photon
D005462:Fluorine Radioisotopes; D009590:Nitrogen Radioisotopes; D013794:Thallium Radioisotopes; D019788:Fluorodeoxyglucose F18; D000641:Ammonia; D003847:Deoxyglucose