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F-18 fluorodeoxyglucose uptake and water-perfusable tissue fraction in assessment of myocardial viability.

Iida H, Ruotsalainen U, Mäki M, Haaparnata M, Bergman J, Voipio-Pulkki LM, Nuutila P, Koshino K, Knuuti J - Ann Nucl Med (2012)

Bottom Line: The image quality of (18)F-FDG was superior to that of (15)O-water.The qualitative PTF showed significantly smaller defects than (18)F-FDG, and the quantitative PTF showed slightly greater values than (18)F-FDG in the infarcted region.The absolute (18)F-FDG uptake was varied in normal segments, and predictive values for the wall motion recovery by the absolute (18)F-FDG was less (accuracy: 80 %) compared with those by the relative (18)F-FDG (accuracy: 87 %) and the quantitative PTF (accuracy: 89 %).

View Article: PubMed Central - PubMed

Affiliation: Turku PET Center, Turku University Central Hospital, 20520, Turku, Finland. iida@ri.ncvc.go.jp

ABSTRACT

Objectives: (15)O-water-perfusable tissue fraction (PTF) has been shown to be a potential index for assessing myocardial viability in PET, an alternative to (18)F-fluorodeoxyglucose (FDG). This study aimed to directly compare these two independent methods in assessing myocardial viability in patients with abnormal wall motion.

Methods: PET study was performed on 16 patients with previous myocardial infarction, before coronary artery bypass graft operation (CABG). The protocol included a (15)O-carbonmonoxide static, a (15)O-water dynamic and an (18)F-FDG dynamic scan, during the euglycemic hyperinsulinemic clamp. Echocardiography was performed at the time of PET and 5-12 months after the CABG, and the wall motion recovery was evaluated on segmental and global bases. Consistency between PTF and (18)F-FDG was evaluated visually and also in a quantitative manner. Predictive values for the wall motion recovery were also compared between the two approaches.

Results: The image quality of (18)F-FDG was superior to that of (15)O-water. The qualitative PTF showed significantly smaller defects than (18)F-FDG, and the quantitative PTF showed slightly greater values than (18)F-FDG in the infarcted region. The two methods were, however, consistent visually and also quantitatively. The predictive values of the wall motion recovery were almost equal between the two approaches. The absolute (18)F-FDG uptake was varied in normal segments, and predictive values for the wall motion recovery by the absolute (18)F-FDG was less (accuracy: 80 %) compared with those by the relative (18)F-FDG (accuracy: 87 %) and the quantitative PTF (accuracy: 89 %).

Conclusion: Despite the small sample size, PTF appears to give consistent results with the (18)F-FDG approach, and might be an alternative viability assessment.

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Schematic diagram of the study protocol. Tr indicates the transmission scan. The second transmission scan was used to confirm that the patient did not move during the period
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Fig1: Schematic diagram of the study protocol. Tr indicates the transmission scan. The second transmission scan was used to confirm that the patient did not move during the period

Mentions: All patients underwent coronary angiography, radionuclide ventriculography, 201Tl SPECT, echocardiography, and PET imaging before the CABG. The PET imaging included scans with 15O-carbonmonoxide, 15O-water and 18F-FDG during euglycemic hyperinsulinemic clamp (see Fig. 1). Angiography was performed 9.1 ± 4.4 weeks before the PET study (all within 4 months). Echocardiography was performed on the same day of the PET imaging and repeated 5–12 months after CABG. Wall motion recovery was then evaluated for each dysfunctional segment in the preoperative study, and this was compared with the results from the PET and SPECT imaging. The consistency of different PET images was also evaluated.Fig. 1


F-18 fluorodeoxyglucose uptake and water-perfusable tissue fraction in assessment of myocardial viability.

Iida H, Ruotsalainen U, Mäki M, Haaparnata M, Bergman J, Voipio-Pulkki LM, Nuutila P, Koshino K, Knuuti J - Ann Nucl Med (2012)

Schematic diagram of the study protocol. Tr indicates the transmission scan. The second transmission scan was used to confirm that the patient did not move during the period
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3475968&req=5

Fig1: Schematic diagram of the study protocol. Tr indicates the transmission scan. The second transmission scan was used to confirm that the patient did not move during the period
Mentions: All patients underwent coronary angiography, radionuclide ventriculography, 201Tl SPECT, echocardiography, and PET imaging before the CABG. The PET imaging included scans with 15O-carbonmonoxide, 15O-water and 18F-FDG during euglycemic hyperinsulinemic clamp (see Fig. 1). Angiography was performed 9.1 ± 4.4 weeks before the PET study (all within 4 months). Echocardiography was performed on the same day of the PET imaging and repeated 5–12 months after CABG. Wall motion recovery was then evaluated for each dysfunctional segment in the preoperative study, and this was compared with the results from the PET and SPECT imaging. The consistency of different PET images was also evaluated.Fig. 1

Bottom Line: The image quality of (18)F-FDG was superior to that of (15)O-water.The qualitative PTF showed significantly smaller defects than (18)F-FDG, and the quantitative PTF showed slightly greater values than (18)F-FDG in the infarcted region.The absolute (18)F-FDG uptake was varied in normal segments, and predictive values for the wall motion recovery by the absolute (18)F-FDG was less (accuracy: 80 %) compared with those by the relative (18)F-FDG (accuracy: 87 %) and the quantitative PTF (accuracy: 89 %).

View Article: PubMed Central - PubMed

Affiliation: Turku PET Center, Turku University Central Hospital, 20520, Turku, Finland. iida@ri.ncvc.go.jp

ABSTRACT

Objectives: (15)O-water-perfusable tissue fraction (PTF) has been shown to be a potential index for assessing myocardial viability in PET, an alternative to (18)F-fluorodeoxyglucose (FDG). This study aimed to directly compare these two independent methods in assessing myocardial viability in patients with abnormal wall motion.

Methods: PET study was performed on 16 patients with previous myocardial infarction, before coronary artery bypass graft operation (CABG). The protocol included a (15)O-carbonmonoxide static, a (15)O-water dynamic and an (18)F-FDG dynamic scan, during the euglycemic hyperinsulinemic clamp. Echocardiography was performed at the time of PET and 5-12 months after the CABG, and the wall motion recovery was evaluated on segmental and global bases. Consistency between PTF and (18)F-FDG was evaluated visually and also in a quantitative manner. Predictive values for the wall motion recovery were also compared between the two approaches.

Results: The image quality of (18)F-FDG was superior to that of (15)O-water. The qualitative PTF showed significantly smaller defects than (18)F-FDG, and the quantitative PTF showed slightly greater values than (18)F-FDG in the infarcted region. The two methods were, however, consistent visually and also quantitatively. The predictive values of the wall motion recovery were almost equal between the two approaches. The absolute (18)F-FDG uptake was varied in normal segments, and predictive values for the wall motion recovery by the absolute (18)F-FDG was less (accuracy: 80 %) compared with those by the relative (18)F-FDG (accuracy: 87 %) and the quantitative PTF (accuracy: 89 %).

Conclusion: Despite the small sample size, PTF appears to give consistent results with the (18)F-FDG approach, and might be an alternative viability assessment.

Show MeSH
Related in: MedlinePlus