title: The role of quantitative Tc-99m-MIBI gated SPECT/F-18-FDG PET imaging in the monitoring of intracoronary bone marrow cell transplantation.
abstract: BACKGROUND
  A lot of unresolved questions still exist concerning the exact mechanism of the beneficial effects of bone marrow cell (BMC) transplantation for myocardial regeneration. The aim of this communication is to report the cases of patients with and without post-transplantation left ventricular function improvement.
  
  
  METHODS
  To this study we included consecutive patients with irreversible damage after a first acute ST-elevation myocardial infarction treated by coronary angioplasty with stent implantation. The irreversible damage was identified by dobutamine echocardiography and confirmed by rest gated Tc-99m-MIBI gated SPECT and in the majority of patients by F-18-FDG PET imaging as well. Using 4D-MSPECT software, we quantified MIBI/FDG uptake and gated SPECT left ventricular ejection fraction, end-diastolic/end-systolic volumes (LVEF, EDV/ESV) before BMC therapy and 3 months later.
  
  
  RESULTS
  The results obtained in the initial group of patients in this study (27 patients in the BMC treated group, 16 patients in the control group) have been published previously [Eur J Nucl Med 2005; 32 (Suppl 1 ): S46]. Among the BMC group, we identified 13 responders to therapy with average LVEF improvement from 43.3% +/- 11% to 51.4% +/- 10.4% and EDV/ESV improvement from 145 ml/84 ml to 133 ml/67 ml. The remaining 14 patients were non-responders to therapy with no significant change in LVEF (39.1% +/- 8.1% versus 39.8% +/- 7.4%), the EDV/ESV increased from 166 ml/105 ml to 188 ml/116 ml. Responders to the cell therapy had prevailing MIBI uptake in the range of 31-50% of maximum in the infarction territory. On the other hand, non-responders to BMC therapy had prevailing MIBI uptake in the range of 0-30% of maximum. Two cases are presented in this report.
  
  
  CONCLUSIONS
  Further studies with a larger cohort of patients would be helpful to evaluate our findings. We observed strong interindividual differences in the effectiveness of the cell therapy. Prevailing residual MIBI uptake in the range of 31-50% of maximum was in the subgroup of responders to the cell therapy.
authors.affiliation: Department of Nuclear Medicine, University Hospital, Olomouc, Czech Republic. milan.kaminek@fnol.cz
authors.forename: Milan
authors.initials: M
authors.lastname: Kamínek
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Meluzín
authors.forename: Stanislav
authors.initials: S
authors.lastname: Janousek
authors.forename: Ladislav
authors.initials: L
authors.lastname: Groch
authors.forename: Roman
authors.initials: R
authors.lastname: Panovský
authors.forename: Martin
authors.initials: M
authors.lastname: Klabusay
authors.forename: Jirí
authors.initials: J
authors.lastname: Mayer
authors.forename: Jirí
authors.initials: J
authors.lastname: Prásek
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Stanícek
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Rehák
authors.forename: Miroslav
authors.initials: M
authors.lastname: Myslivecek
mesh_terms: D000328:Adult; D001854:Bone Marrow Cells / Q000166:cytology*; D016026:Bone Marrow Transplantation / Q000379:methods*; D004452:Echocardiography; D019788:Fluorodeoxyglucose F18 / Q000494:pharmacology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology; D009206:Myocardium / Q000473:pathology; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals / Q000494:pharmacology*; D017256:Technetium Tc 99m Sestamibi / Q000494:pharmacology*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D017256:Technetium Tc 99m Sestamibi