Limits...
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.

Show MeSH

Related in: MedlinePlus

Absolute and relative 18F-FDG uptake and water-perfusable tissue fraction (PTF) in control segments (C) and in revascularized segments. Arrows correspond to the threshold values to discriminate between the recovered (R) and non-recovered (NR) (see text)
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3475968&req=5

Fig5: Absolute and relative 18F-FDG uptake and water-perfusable tissue fraction (PTF) in control segments (C) and in revascularized segments. Arrows correspond to the threshold values to discriminate between the recovered (R) and non-recovered (NR) (see text)

Mentions: Predictive values for the wall motion recovery resulted from the quantitative analysis are summarized in Table 4 and Fig. 5. The most accurate results were obtained using the limit values of 0.62 ml/min/g in MBF, 0.34 ml/min/ml in MBFt, 0.51 g/ml in PTF, 34.4 mol/100 g/min in the absolute 18F-FDG uptake and 67 % in the relative 18F-FDG uptake. The positive predictive values obtained with the different variables were nearly equal among the variables. However, the absolute 18F-FDG uptake and MBF showed clearly lower negative predictive values than relative 18F-FDG uptake and PTF values. Figure 6 shows the results of ROC analysis for FDG uptake and PTF. The ROC analysis demonstrated greater area under the curve in relative rather than absolute values for both FDG and PTF. The area under the curve was slightly greater with PTF rather than relative FDG. Combination of FDG with MBF is of interest in terms of the improved accuracy in determining wall motion recovery. The best accuracy was obtained by the combination of relative 18F-FDG uptake and relative MBF (Table 4).Table 4


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)

Absolute and relative 18F-FDG uptake and water-perfusable tissue fraction (PTF) in control segments (C) and in revascularized segments. Arrows correspond to the threshold values to discriminate between the recovered (R) and non-recovered (NR) (see text)
© Copyright Policy
Related In: Results  -  Collection

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

Fig5: Absolute and relative 18F-FDG uptake and water-perfusable tissue fraction (PTF) in control segments (C) and in revascularized segments. Arrows correspond to the threshold values to discriminate between the recovered (R) and non-recovered (NR) (see text)
Mentions: Predictive values for the wall motion recovery resulted from the quantitative analysis are summarized in Table 4 and Fig. 5. The most accurate results were obtained using the limit values of 0.62 ml/min/g in MBF, 0.34 ml/min/ml in MBFt, 0.51 g/ml in PTF, 34.4 mol/100 g/min in the absolute 18F-FDG uptake and 67 % in the relative 18F-FDG uptake. The positive predictive values obtained with the different variables were nearly equal among the variables. However, the absolute 18F-FDG uptake and MBF showed clearly lower negative predictive values than relative 18F-FDG uptake and PTF values. Figure 6 shows the results of ROC analysis for FDG uptake and PTF. The ROC analysis demonstrated greater area under the curve in relative rather than absolute values for both FDG and PTF. The area under the curve was slightly greater with PTF rather than relative FDG. Combination of FDG with MBF is of interest in terms of the improved accuracy in determining wall motion recovery. The best accuracy was obtained by the combination of relative 18F-FDG uptake and relative MBF (Table 4).Table 4

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