Individual differences in the effectiveness of intracoronary bone marrow cell transplantation assessed by gated sestamibi SPECT/FDG PET imaging.
BACKGROUND
The impact of different levels of tracer uptake on improvements of left-ventricular (LV) function was analyzed in patients treated by intracoronary bone marrow cell (BMC) transplantation.


RESULTS
Thirty-one patients with irreversible damage after their first acute myocardial infarction (MI), as confirmed by sestamibi single-photon emission computed tomography (MIBI SPECT)/fluorodeoxyglucose positron emission tomography (FDG PET), underwent high-dose (1 x 10(8) cells) BMC transplantation, whereas 31 similar patients were randomly integrated into a control group. In 11 BMC-treated patients with very low sestamibi uptake at less than 30% of maximum in the infarcted area, the mean left-ventricular ejection fraction (LVEF) improved after 3 months of follow-up by 3% only, and mean end-diastolic/end-systolic volumes (EDV/ESV) enlarged by 10/1 mL (P = NS vs controls). In 20 BMC-treated patients with higher sestamibi uptake in the range of 31% to 50% of maximum, LVEF improved by 7%, and EDV/ESV decreased by 5/12 mL (P < .05 vs BMC-treated subgroup with low MIBI uptake and controls). No similar categorization was seen in the control group: in patients with higher sestamibi uptake or very low uptake, the LVEF increased by 2% and 3% only, and the EDV/ESV enlarged in both subgroups by 12/4 mL and 12/2 mL, respectively (P = NS).


CONCLUSIONS
Our results suggest the capability of SPECT/PET imaging to select patients who will receive the maximum benefit from BMC therapy.
Department of Nuclear Medicine, University Hospital Olomouc, Czech Republic. milankaminek@seznam.cz
Milan
M
Kaminek
Jaroslav
J
Meluzin
Roman
R
Panovsky
Stanislav
S
Janousek
Jiri
J
Mayer
Jiri
J
Prasek
Jaroslav
J
Stanicek
Jan
J
Lukl
D016026:Bone Marrow Transplantation / Q000000981:diagnostic imaging* / Q000379:methods; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000601:surgery*; D017063:Outcome Assessment, Health Care / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000517:prevention & control*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18