The predictive value of 201Tl rest-redistribution and 18F-fluorodeoxyglucose SPECT for wall motion recovery after recent reperfused myocardial infarction.
201Tl and 18F-FDG are useful for acute myocardial infarction (MI) assessment. The goal of this study was to compare their predictive value for wall motion recovery in the culprit area after a recent reperfused MI using SPECT technique.


METHODS
Forty-one patients (mean age: 56 +/- 12 years) were included, 81% of them male; all were studied within 1-24 days post MI. They underwent angioplasty in 27 cases (12 primary); bypass grafting in 10 cases and successful thrombolysis in 4. SPECT 201Tl injected at rest and redistribution (R-R) and also 18F-FDG, were performed on different days. Processed tomograms were interpreted blinded to clinical or angiographic data. Segmental wall motion assessed with echocardiography at baseline was compared with the 3 month follow up.


RESULTS
Sensitivity [Confidence Interval] for 201Tl R-R was 74.6% [60.5-84.5], for FDG it was 82.1% [70.8-90.4]; specificities were 73% [64.3-80.5] and 54.8% [45.6-63.7], respectively. 18F-FDG tended to be more sensitive than 201Tl R-R, but the latter was more specific (p < 0.0004). Both 201Tl RR and 18F-FDG presented high negative predictive value (p: ns).


CONCLUSIONS
In recent MI, SPECT 201Tl R-R is a valuable and widely available technique for viability detection, with similar sensitivity and significant better specificity than SPECT 18F-FDG.
González
Patricio
P
Medicina Nuclear, Hospital Clínico Universidad de Chile.
Massardo
Teresa
T
Coll
Claudia
C
Humeres
Pamela
P
Sierralta
Paulina
P
Jofré
M Josefina
MJ
Yovanovich
Jorge
J
Aramburu
Ivonne
I
Brugère
Solange
S
Chamorro
Hernán
H
D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals; D020127:Recovery of Function; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D013793:Thallium; D015912:Thrombolytic Therapy / Q000379:methods; D014022:Tissue Survival / Q000502:physiology; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; C027549:thallium chloride; D013793:Thallium