Gated metabolic positron emission tomography (GAPET) of the myocardium: 18F-FDG-PET to optimize recognition of myocardial hibernation.
The aim of this study was to test the feasibility of the direct measurement of global and regional metabolic wall thickening with 18F-FDG-gated positron emission tomography (PET) in patients with coronary artery disease (CAD). Based on non-invasive (ECG, echocardiography) and invasive [cineventriculography (CVG), coronary angiography] investigations, 12 patients with CAD underwent gated metabolic PET studies with 18F-FDG. Myocardial wall thickening and wall motion analysis from short-axis horizontal and vertical long-axis slices were studied. PET-derived global ejection fraction correlated with CVG-derived global ejection fraction (r = 0.75). Forty-eight of 72 segments investigated were normal (66.7%); 24 of 72 segments were abnormal (33.3%), of which 10 (41.7%) were considered to be hibernating. Four segments were classified as partially fibrotic (16.7%) and 10 (41.7%) as entirely scar-like. Gated PET (8 gates, tail drop corrected) allows quantification of global and regional ejection fraction to detect metabolic wall thickening in left ventricular segments with dyskinesia on CVG due to critical CAD stenoses. By improving data analysis methods, our approach may enhance the detection of viable, hibernating myocardium before revascularization.
Hör
G
G
Klinik für Nuklearmedizin, Klinik der Johann Wolfgang Goethe-Universität, Frankfurt-am-Main, Germany.
Kranert
W T
WT
Maul
F D
FD
Schröder
O
O
Karimian-Tatriz
A
A
Geb
O
O
Baum
R P
RP
Scherer
U W
UW
D003327:Coronary Disease / Q000000981:diagnostic imaging*; D005355:Fibrosis; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D015637:Gated Blood-Pool Imaging; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D009203:Myocardial Infarction / Q000000981:diagnostic imaging; D017682:Myocardial Stunning / Q000000981:diagnostic imaging* / Q000473:pathology; D009206:Myocardium / Q000473:pathology; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012016:Reference Values; D017256:Technetium Tc 99m Sestamibi; D013794:Thallium Radioisotopes; D014055:Tomography, Emission-Computed
D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes; D019788:Fluorodeoxyglucose F18; D017256:Technetium Tc 99m Sestamibi