PET detection of viable tissue in myocardial segments with persistent defects at T1-201 SPECT

Journal Article · Sat Jul 01 00:00:00 EDT 1989 · Radiology; (United States)

DOI:https://doi.org/10.1148/radiology.172.1.2787037· OSTI ID:5601633

Brunken, R C; Kottou, S; Nienaber, C A; Schwaiger, M; Ratib, O M; Phelps, M E; Schelbert, H R

To assess myocardial glucose metabolism and perfusion in 142 myocardial segments with defects seen at thallium-201 single photon emission computed tomography (SPECT), 27 studies with positron emission tomography (PET) utilizing nitrogen-13 ammonia and fluorine-18 deoxyglucose were performed in 26 patients. Myocardial infarction was defined on the basis of concordant reductions in segmental perfusion and glucose utilization; myocardial ischemia, on the basis of preservation of glucose utilization (metabolic viability) in segments with hypoperfusion at rest. Of the 142 segments analyzed, 101 had fixed defects, 31 had partially reversible defects, and ten had completely reversible defects. Preserved glucose utilization was identified in 47 (46.5%) of the segments with fixed defects and 20 (64.5%) of the segments with partially reversible defects. Of the ten segments with completely reversible defects, five (50%) were normal, and five (50%) exhibited ischemia at PET. Visual improvement in a persistent thallium defect at delayed imaging was not associated with residual glucose metabolic activity. Thus, PET can be used to detect glucose metabolic activity in a significant proportion of myocardial segments with fixed or partially redistributing defects seen at thallium SPECT, which suggests that the extent of tissue viability in patients with ischemic heart disease is underestimated at thallium scintigraphy.

• OSTI ID: 5601633
• Journal Information: Radiology; (United States), Journal Name: Radiology; (United States) Vol. 172:1; ISSN RADLA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ALDEHYDES
BETA DECAY RADIOISOTOPES
BETA-PLUS DECAY RADIOISOTOPES
BODY
CARBOHYDRATES
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COMPUTERIZED TOMOGRAPHY
DATA COVARIANCES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
EMISSION COMPUTED TOMOGRAPHY
FLUORINE 18
FLUORINE ISOTOPES
GLUCOSE
HEART
HEAVY NUCLEI
HEXOSES
HOURS LIVING RADIOISOTOPES
ISCHEMIA
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LIGHT NUCLEI
METABOLISM
MINUTES LIVING RADIOISOTOPES
MONOSACCHARIDES
MUSCLES
MYOCARDIAL INFARCTION
MYOCARDIUM
NITROGEN 13
NITROGEN ISOTOPES
NUCLEI
ODD-EVEN NUCLEI
ODD-ODD NUCLEI
ORGANIC COMPOUNDS
ORGANS
PATIENTS
PERFUSED ORGANS
POSITRON COMPUTED TOMOGRAPHY
RADIOISOTOPES
SACCHARIDES
SECONDS LIVING RADIOISOTOPES
SENSITIVITY ANALYSIS
SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
THALLIUM 201
THALLIUM ISOTOPES
TOMOGRAPHY
VASCULAR DISEASES