A Comparison of Thallium-201 Spect and F-18 Deoxyglucose Positron Emission Tomography in Assessing Myocardial Viability

  • Syed Sajid Husain Veterans Administration Medical Center State University of New York at Buffalo Positron Imaging Center Buffalo New York United States of America
  • J Gona Veterans Administration Medical Center State University of New York at Buffalo Positron Imaging Center Buffalo New York United States of America
  • A Pulimamidy Veterans Administration Medical Center State University of New York at Buffalo Positron Imaging Center Buffalo New York United States of America
Keywords: Myocardial viability, thallium, fluorodeoxyglucose, PET, SPECT

Abstract

DOI: http://dx.doi.org/10.5915/30-2-16360

Assessment of myocardial viability prior to revascularization procedures is an important clinical consideration for improved functional recovery of regional left ventricular dysfunction. In chronic coronary artery disease, impaired left ventricular function, at least in part, is due to ischemic or hibernating myocardium rather than just myocardial fibrosis. Functional recovery of the left ventricular dysfunction is dependent on a timely revascularization of the ischemic and/or hibernating myocardium. The assessment of myocardial viability by regional ventricular function measurements by various other modalities is imprecise. Myocardial viability in chronic ischemia, hibernating, or stunned myocardium can be assessed by Thallium-201 single photon emission tomography (SPECT) in a majority of the cases. The positron emission tomography (PET) F-
18 Deoxyglucose (FDG) imaging is considered to be an accurate marker for differentiating hibernating, but viable, myocardium from infarction in a subset of patients not resolved with thallium-201 imaging. In our experience, overall sensitivity for Thallium-201 SPECT imaging for viability was 60% with a negative predictive value of 69.9% and accuracy greater than 79%.

Author Biographies

Syed Sajid Husain, Veterans Administration Medical Center State University of New York at Buffalo Positron Imaging Center Buffalo New York United States of America

M.D.

Veterans Administration Medical Center
State University of New York at Buffalo
Positron Imaging Center
Buffalo
New York
United States of America 

J Gona, Veterans Administration Medical Center State University of New York at Buffalo Positron Imaging Center Buffalo New York United States of America

MD

Veterans Administration Medical Center
State University of New York at Buffalo
Positron Imaging Center
Buffalo
New York
United States of America

A Pulimamidy, Veterans Administration Medical Center State University of New York at Buffalo Positron Imaging Center Buffalo New York United States of America

MD

Veterans Administration Medical Center
State University of New York at Buffalo
Positron Imaging Center
Buffalo
New York
United States of America

References

Tamaki N, Ohtani H. Metabolic activity in areas of new fill in a:fterThallium-201 reinjection: Comparison with PET using Fluorine-18-Deoxyglucose. J Nucl Med. 1991;32:673-8.

Bonow RO, Dilsizian V. Identification of viable myocardium with Ch. CAD, comparison of Thallium scintigraphy with rcinjcction and PET inlaging with FOG. Circulation. 1991 ;83:26-37.

Knuuti MJ, Nuutila P. The value of quantitative ana lysis of glucose utilization in detection of myocardial viability by PET. J Nucl Med. 1993;34:2068-75.

Burt RW, Perkins OW. Direct comparison of Fluorine- 18-FDG SPECT, FOG PET and rest Thalliurn-201 SPECT for detection of myocardial viability. J Nucl Med. 1995;36: 176-9.

Brunken R, Kottou S. PET detection of viable tissue in myocardial segments with persistent defects at TL-20 l SPECT. J of Radiology. 1989;65-73.

Bruce B, B Massie. Improved regional ventricular function after successful surgical revascularization. JACC 1984;3:902-8.

Altehoefer C, vom Dahl J, Biedermann M, Uebis R, Beilin I, Sheehan F, Hanrath P, Buell U. Significance of defect severity in technetium-99m-MIBI SPECT at rest to assess myocardial viability: comparison with fluorine-18-FDG PET. J Nucl Med. 1994 Apr;35(4):569-74.

Dilsizian V, Bonow RO. Current diagnostic techniques of assessing myocardial viability in patients with hibernating and stunned myocardium. Circulation. 1993 Jan;87(1):1-20.

Chua T, Kiat H. Gated Tc-99m-Sestamibi for simultaneous assessment of stress myocardial perfusion post-exercise regional ventricular function and myocardial viability. J Am Coll Cardiol. 1994;23: 1107-14.

Knuutii MJ, Saraste M. Myocardial viability: FOG PET in prediction of wall motion recovery after revascularization. Am Heart J. 1994;127:785-96.

Tillisch J, Brunken R, Marshall R, Schwaiger M, Mandelkern M, Phelps M, Schelbert H. Reversibility of cardiac wall-motion abnormalities predicted by positron tomography. N Engl J Med. 1986 Apr 3;314(14):884-8.

Tamaki N, Yonekura Y. PET using FOG in evaluation of coronary artery bypass grafting. Am J Card. 1989;64:860-5.

Published
1998-04-01
Section
Original Articles