99mTc-Sestamibi SPECT is a useful technique for viability detection: results of a comparison with NH3/FDG PET.
OBJECTIVE
Assessment of myocardial viability by 99mTc-Sestamibi Single Photon Emission Computerized Tomography (SPECT) has been suggested as a more readily available and cheaper alternative to Positron Emission Tomography (PET) with 13N-ammonia (NH3) and 18F-fluoro-deoxy-glucose (FDG). We hypothesized that a semi-quantitative evaluation by SPECT could delineate myocardial viability with an acceptable concordance to PET.


METHODS
Fifty patients (age 57+/-7 years; ejection fraction 28 +/- 8%), with ischemic cardiomyopathy, underwent SPECT and PET imaging in random order. Viability by SPECT was defined as a defect size <50% of the segment area, or a defect representing > or =50% of the segment but with a mean activity > or =50% of peak activity. PET viability was defined as a perfusion score >2 and FDG score < or =2 (five-point scale, 0 = normal, 4 = absent activity).


RESULTS
By segmental comparison to PET. SPECT yielded a sensitivity and specificity of 87% and 82% for detection of viable myocardium. The positive and negative predictive values were 96% and 58%, respectively.


CONCLUSIONS
In patients with severe ischemic cardiomyopathy 99mTc-Sestamibi SPECT can delineate viable myocardium with an acceptable segmental concordance to NH3/FDG PET.
Kaltoft
A
A
Department of Nuclear Medicine, Aarhus University Hospital, Denmark. akk@nucmed.auh.dk. akk@nucmed.auh.dk
Bøttcher
M
M
Sand
N P
NP
Flø
C
C
Nielsen
T T
TT
Rehling
M
M
D000328:Adult; D000368:Aged; D000641:Ammonia; D009202:Cardiomyopathies / Q000150:complications / Q000000981:diagnostic imaging; D002470:Cell Survival / Q000502:physiology*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000648:ultrastructure; D009590:Nitrogen Radioisotopes; D011897:Random Allocation; D013318:Stroke Volume / Q000502:physiology; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon
D009590:Nitrogen Radioisotopes; D019788:Fluorodeoxyglucose F18; D000641:Ammonia; D017256:Technetium Tc 99m Sestamibi