title: Evaluation of myocardial viability following acute myocardial infarction using 201Tl SPECT after thallium-glucose-insulin infusion--comparison with 18F-FDG positron emission tomography.
abstract: OBJECTIVE
  The aim of this study was to evaluate myocardial viability in patients after acute myocardial infarction (AMI). We compared 201Tl SPECT after 201Tl with GIK (10% glucose 250 ml, insulin 5 U and KCl 10 mEq) infusion (GIK-201Tl) with resting 201Tl and 99mTc-pyrophosphate (PYP) dual SPECT, positron emission computed tomography (PET) using 18F-fluorodeoxyglucose (18F-FDG) in 21 patients with their first AMI, who all underwent successful reperfusion. GIK-201Tl SPECT, 201Tl and 99mTc-PYP dual SPECT were done within 10 days after admission and 18F-FDG-PET was performed at 3 weeks. GIK-201Tl SPECT was obtained after 30 min of GIK-201Tl infusion. 18F-FDG (370 MBq) was injected intravenously after oral glucose (1 g/ kg) loading, and then PET was obtained. PET and SPECT images were divided into 20 segments. Regional tracer uptake was scored using a 4-point scoring system (3 = normal to 0 = defect), and summed to a regional uptake score (RUS). Regional area means the infarcted area in which 99mTc-PYP accumulated. The number of decreased uptake segments (ES) was then determined. The infarcted area was defined as the area of 99mTc-PYP uptake.
  
  
  RESULTS
  The ESs for the GIK-201Tl and 18F-FDG-PET images were significantly lower than the number of 99mTc-PYP uptake segments. The RUS for GIK-201Tl was higher than that for resting-201Tl imaging and similar to those for 18F-FDG-PET.
  
  
  CONCLUSIONS
  In the detection of myocardial viability following AMI, GIK-201Tl imaging is useful with findings similar to those of 18F-FDG-PET.
authors.affiliation: Gunma Prefectural Cardiovascular Center, Japan. toyama.t@cvc.pref.gunma.jp
authors.forename: Takuji
authors.initials: T
authors.lastname: Toyama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hoshizaki
authors.forename: Ryotaro
authors.initials: R
authors.lastname: Seki
authors.forename: Naoki
authors.initials: N
authors.lastname: Isobe
authors.forename: Shigeru
authors.initials: S
authors.lastname: Oshima
authors.forename: Koichi
authors.initials: K
authors.lastname: Taniguchi
authors.forename: Kyosuke
authors.initials: K
authors.lastname: Higuchi
authors.forename: Hidenori
authors.initials: H
authors.lastname: Seki
authors.forename: Takashi
authors.initials: T
authors.lastname: Hatori
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kurabayashi
authors.forename: Keigo
authors.initials: K
authors.lastname: Endo
mesh_terms: D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose; D006801:Humans; D007328:Insulin; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000601:surgery; D049268:Positron-Emission Tomography / Q000379:methods; D011188:Potassium; D011379:Prognosis; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013794:Thallium Radioisotopes; D014022:Tissue Survival; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D016896:Treatment Outcome
chemical_list: D007328:Insulin; D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes; C030396:glucose-insulin-potassium cardioplegic solution; D019788:Fluorodeoxyglucose F18; D005947:Glucose; D011188:Potassium