Identification of viable myocardium in patients with chronic coronary artery disease and left ventricular dysfunction. Comparison of thallium scintigraphy with reinjection and PET imaging with sup 18 F-fluorodeoxyglucose

Journal Article · Tue Jan 01 00:00:00 EST 1991 · Circulation; (USA)

DOI:https://doi.org/10.1161/01.CIR.83.1.26· OSTI ID:6213303

Bonow, R O; Dilsizian, V; Cuocolo, A; Bacharach, S L ^[1]

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1. National Heart, Lung and Blood Institute, Bethesda, MD (USA)

In patients with chronic coronary artery disease and left ventricular dysfunction, the distinction between ventricular dysfunction arising from myocardial fibrosis and ischemic, but viable, myocardium has important clinical implications. By positron emission tomography (PET), enhanced fluorine-18-labeled fluorodeoxyglucose (FDG) uptake in myocardial segments with impaired function and reduced blood flow is evidence of myocardial viability. Reinjection of thallium-201 at rest immediately after stress-redistribution imaging may also provide evidence of myocardial viability by demonstrating thallium uptake in regions with apparently irreversible defects. To compare these two methods, we studied 16 patients with chronic coronary artery disease and left ventricular dysfunction, all of whom had irreversible defects on standard exercise-redistribution thallium single-photon emission computed tomography (SPECT) imaging. Thallium was reinjected immediately after the redistribution study, and SPECT images were reacquired. The patients also underwent PET imaging with FDG and oxygen-15-labeled water. A total of 432 myocardial segments were analyzed from comparable transaxial tomograms, of which 166 (38%) had irreversible thallium defects on redistribution images before reinjection. FDG uptake was demonstrated in 121 (73%) of these irreversible defects. Irreversible defects were then subgrouped according to the degree of thallium activity, relative to peak activity in normal regions. Irreversible defects with only mild (60-85% of peak activity) or moderate (50-59% of peak) reduction in thallium activity were considered viable on the basis of FDG uptake in 91% and 84% of these segments, respectively. In contrast, in irreversible defects with severe reduction in thallium activity (less than 50% of peak), FDG uptake was present in 51% of segments.

• OSTI ID: 6213303
• Journal Information: Circulation; (USA), Vol. 83:1; ISSN 0009-7322
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARDIOVASCULAR DISEASES
DIAGNOSIS
MYOCARDIUM
IMAGE PROCESSING
BLOOD FLOW
COMPARATIVE EVALUATIONS
FLUORINE 18
GLUCOSE
OXYGEN 15
PATIENTS
POSITRON COMPUTED TOMOGRAPHY
SCINTISCANNING
SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
THALLIUM 201
ALDEHYDES
BETA DECAY RADIOISOTOPES
BETA-PLUS DECAY RADIOISOTOPES
BODY
CARBOHYDRATES
CARDIOVASCULAR SYSTEM
COMPUTERIZED TOMOGRAPHY
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
EMISSION COMPUTED TOMOGRAPHY
EVEN-ODD NUCLEI
FLUORINE ISOTOPES
HEART
HEAVY NUCLEI
HEXOSES
HOURS LIVING RADIOISOTOPES
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LIGHT NUCLEI
MINUTES LIVING RADIOISOTOPES
MONOSACCHARIDES
MUSCLES
NUCLEI
ODD-EVEN NUCLEI
ODD-ODD NUCLEI
ORGANIC COMPOUNDS
ORGANS
OXYGEN ISOTOPES
PROCESSING
RADIOISOTOPE SCANNING
RADIOISOTOPES
SACCHARIDES
SECONDS LIVING RADIOISOTOPES
THALLIUM ISOTOPES
TOMOGRAPHY
550601* - Medicine- Unsealed Radionuclides in Diagnostics