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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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Related in: MedlinePlus

Example images of extra-vascular tissue density (Dev), the blood volume (VB), 15O-water washout phase (WO, or qualitative PTF), and 18F-FDG uptake, obtained from 2 typical cases. In case 1, the wall motion was irreversible in the anterior wall segment (arrow, a), which was well predicted by both WO and FDG as complete defect. In case 2, wall motion was reduced in the anterior wall (arrow, b), but was not improved in the apex (arrow, c). These were also consistent with the findings in both WO and FDG. Image quality of 18F-FDG was better than that of WO, but both images provided consistent results
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Fig2: Example images of extra-vascular tissue density (Dev), the blood volume (VB), 15O-water washout phase (WO, or qualitative PTF), and 18F-FDG uptake, obtained from 2 typical cases. In case 1, the wall motion was irreversible in the anterior wall segment (arrow, a), which was well predicted by both WO and FDG as complete defect. In case 2, wall motion was reduced in the anterior wall (arrow, b), but was not improved in the apex (arrow, c). These were also consistent with the findings in both WO and FDG. Image quality of 18F-FDG was better than that of WO, but both images provided consistent results

Mentions: Figure 2 shows examples of calculated images obtained from typical two studies, demonstrating the extravascular tissue density (Dev), blood volume (VB), 15O-water image at a washout phase (i.e., the qualitative PTF), and 18F-FDG uptake. In case 1, both PTF and FDG images showed a large defect in the anterior wall region, and these two images were considered to be consistent in all segments. No recovery of wall motion was detected after revascularization. In case 2, the anterior, anteroseptal and apical walls were akinetic. The FDG and PTF images indicated preserved myocardial viability in the former two segments but scar in the apex. After the revascularization, the anterior and anteroseptal segments were completely recovered but no change was detected in the apex.Fig. 2


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)

Example images of extra-vascular tissue density (Dev), the blood volume (VB), 15O-water washout phase (WO, or qualitative PTF), and 18F-FDG uptake, obtained from 2 typical cases. In case 1, the wall motion was irreversible in the anterior wall segment (arrow, a), which was well predicted by both WO and FDG as complete defect. In case 2, wall motion was reduced in the anterior wall (arrow, b), but was not improved in the apex (arrow, c). These were also consistent with the findings in both WO and FDG. Image quality of 18F-FDG was better than that of WO, but both images provided consistent results
© Copyright Policy
Related In: Results  -  Collection

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

Fig2: Example images of extra-vascular tissue density (Dev), the blood volume (VB), 15O-water washout phase (WO, or qualitative PTF), and 18F-FDG uptake, obtained from 2 typical cases. In case 1, the wall motion was irreversible in the anterior wall segment (arrow, a), which was well predicted by both WO and FDG as complete defect. In case 2, wall motion was reduced in the anterior wall (arrow, b), but was not improved in the apex (arrow, c). These were also consistent with the findings in both WO and FDG. Image quality of 18F-FDG was better than that of WO, but both images provided consistent results
Mentions: Figure 2 shows examples of calculated images obtained from typical two studies, demonstrating the extravascular tissue density (Dev), blood volume (VB), 15O-water image at a washout phase (i.e., the qualitative PTF), and 18F-FDG uptake. In case 1, both PTF and FDG images showed a large defect in the anterior wall region, and these two images were considered to be consistent in all segments. No recovery of wall motion was detected after revascularization. In case 2, the anterior, anteroseptal and apical walls were akinetic. The FDG and PTF images indicated preserved myocardial viability in the former two segments but scar in the apex. After the revascularization, the anterior and anteroseptal segments were completely recovered but no change was detected in the apex.Fig. 2

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