title: Practical assessment of myocardial viability with a positron coincidence gamma camera using 18F-fluorodeoxyglucose in acute myocardial infarction: comparison with dedicated positron emission tomography and 201Tl single photon emission computed tomography.
abstract: OBJECTIVE
  2-[(18)F] fluoro-2-deoxy-D-glucose ((18)F-FDG) began to be supplied commercially to our hospital, which does not have a cyclotron, in autumn of 2005. The purpose of this study was to compare the utility of a dual-head positron coincidence detection (PCD) gamma camera in the detection of myocardial viability using (18)F-FDG with that of dedicated positron emission tomography (PET) and with that of thallium-201 ((201)Tl) single photon emission computed tomography (SPECT).
  
  
  METHODS
  A total of 15 patients (14 men and 1 woman, mean age: 60+/-7 years, range: 46-73) with a large acute myocardial infarction (AMI) underwent (18)F-FDG PET, (18)F-FDG PCD imaging after oral glucose loading (75 g) and (201)Tl SPECT imaging. We divided the SPECT and PET images into a total of 20 segments, and semiquantitative visual analysis was performed by assessing regional tracer activities on a 4-point scoring system (DS): 0=normal uptake, 1=mildly reduced uptake, 2=severely reduced uptake, and 3=no uptake. We summed the DS in each patient as the total DS (TDS).
  
  
  RESULTS
  The TDS of the (18)F-FDG PET image was 14.4+/-7.7. The TDS of the (18)F-FDG PCD image was 18.7+/-7.7. The TDS of the (201)Tl SPECT image was 24.1+/-11.5. The TDS of the (18)F-FDG PET image was significantly smaller than that of the (18)F-FDG PCD image. The TDS of the (18)F-FDG PET image was significantly smaller than that of the (201)Tl SPECT image. The TDS of the (18)F-FDG PCD image was significantly smaller than that of the (201)Tl SPECT image.
  
  
  CONCLUSIONS
  The findings of the project suggest that (18)F-FDG PCD is a good modality based on its accuracy, convenience, and cost-performance for detecting myocardial viability in hospitals that do not have a PET system.
authors.affiliation: Department of Medicine and Biological Science, Graduate School of Medical Sciences, Gunma University, 3-39-15 Showamachi, Gunma-pref., Maebashi 371-8511, Japan. sekiryo@d9.dion.ne.jp
authors.forename: Ryotaro
authors.initials: R
authors.lastname: Seki
authors.forename: Hidenori
authors.initials: H
authors.lastname: Seki
authors.forename: Takuji
authors.initials: T
authors.lastname: Toyama
authors.forename: Keiko
authors.initials: K
authors.lastname: Koyama
authors.forename: Keigo
authors.initials: K
authors.lastname: Endo
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kurabayashi
mesh_terms: D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D015902:Gamma Cameras; D006321:Heart / Q000000981:diagnostic imaging / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D013794:Thallium Radioisotopes; D014022:Tissue Survival; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D013794:Thallium Radioisotopes; D019788:Fluorodeoxyglucose F18