Evaluation of the clinical value of combination of 99mTc-MIBI myocardial SPECT and 18F-FDG PET in assessing myocardial viability.
OBJECTIVE
To evaluate the value of 18F-FDG PET metabolic imaging and 99mTc-MIBI SPECT in the identification of myocardial viability in patients with previous myocardial infarction and left ventricular dysfunction.


METHODS
18F-FDG PET (made in China) and 99mTc-MIBI SPECT were performed in 60 patients (pts) (age 54+/-9 yr) with myocardial infarction before revascularization. Before and after revascularization, LVEF and wall motion were measured with echocardiography in 36 pts (Group A), and myocardial perfusion was evaluated in 24 pts (Group B).


RESULTS
According to the interpretation of perfusion and metabolic images, myocardial segments were classified into mismatch (MM): reduced myocardial perfusion and normal FDG uptake or match (M): reduced perfusion and FDG uptake. Out of 264 segments with hypoperfusion, 145 (54.9%) were MM, suggesting viable myocardium (G-A1 and G-B1), 119 (45.1%) were M, suggesting necrosis (G-A2 and G-B2). After revascularization, LVEF was increased in G-A1 (49+/-15% vs. 59+/-7%, p<0.05), and in G-B1 (50+/-8% vs. 59+/-12%, p<0.05), but was not improved in G-A2 and G-B2. LVEDD was decreased in G-A1 and G-B1 (p<0.05) and was unchanged in G-A2 and G-B2. The positive predictive value (PPV) of FDG PET for improvement of regional wall motion after revascularization was 88%, and the negative predictive value (NPV) was 72.6%. The PPV for improvement of perfusion was 84.1%, NPV was 85%, and accuracy was 84.4%.


CONCLUSIONS
18F-FDG imaging with Chinese PET has clinical value for assessing myocardial viability and identifying patients who will benefit from revascularization.
Zhang
X
X
Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Liu
X
X
Shi
R
R
Wu
Q
Q
Gao
R
R
Liu
Y
Y
Hu
S
S
Guo
S
S
Xie
F
F
Li
Y
Y
D005069:Evaluation Studies as Topic; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000628:therapy; D009204:Myocardial Revascularization; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D014055:Tomography, Emission-Computed; D015899:Tomography, Emission-Computed, Single-Photon; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging
D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D017256:Technetium Tc 99m Sestamibi