Comparison of multidetector CT with F-18-FDG-PET and SPECT in the assessment of myocardial viability in patients with myocardial infarction: a preliminary study.
OBJECTIVE
To evaluate the ability of MDCT to detect a nonviable myocardium in patients with myocardial infarction (MI).


METHODS
This study included 17 patients with MI in the acute (n=13) or chronic stage (n=4). MDCT, SPECT, and F-18-FDG-PET were performed in 10 patients during the acute stage and in 2 during the chronic stage of MI. MDCT and SPECT were performed in 13 patients with acute stage and in 4 with chronic stage of MI. Sixteen-slice MDCT was performed 10 min after injection of 120 mL of nonionic contrast media. MDCT, SPECT and PET images were analyzed using a 17-segment model. The depth of hyperenhancement >2/3 was defined as nonviable at MDCT.


RESULTS
MDCT and SPECT were concordant in localizing the MI in 84.2% (272/323 segments) and were discordant in 15.8% (51/323). MDCT and PET were concordant in localizing MI in 89.2% (182/204) and discordant in 10.8% (22/204). The sensitivity, specificity and diagnostic accuracy of MDCT in determining the nonviable segments were 70.4%, 85.3%, 81.4% as compared with PET, respectively, and 69.4%, 81.8%, 79.9% compared with SPECT, respectively, and 73.5%, 79.4%, 78.4% compared with combined PET and SPECT, respectively. MDCT findings suggested nonviability in additional 16 segments (5.0%) and 7 segments (3.4%) where MI was not detected on SPECT and FDG-PET, respectively.


CONCLUSIONS
MDCT is useful for determining myocardial viability in patients with myocardial infarction and more sensitive than SPECT and FDG-PET in detecting a nonviable myocardium.
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Republic of Korea.
In Ho
IH
Lee
Yeon Hyeon
YH
Choe
Kyung Han
KH
Lee
Eun-Seok
ES
Jeon
Jin-Ho
JH
Choi
D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis*; D017682:Myocardial Stunning / Q000175:diagnosis* / Q000209:etiology*; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18