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Comparative assessment of 18F-fluorodeoxyglucose PET and 99mTc-tetrofosmin SPECT for the prediction of functional recovery in patients with reperfused acute myocardial infarction.

AbstractPURPOSE:
Although preserved glucose metabolism is considered to be a marker of myocardial viability in the chronic stage, it has not been fully elucidated whether this is also true with regard to reperfused acute myocardial infarction (AMI). The aim of this study was to compare the diagnostic performance of(99m)Tc-tetrofosmin SPECT and(18)F-fluorodeoxyglucose (FDG) PET for the prediction of functional recovery in reperfused AMI.
METHODS:
The study population comprised 28 patients. Both tetrofosmin SPECT and FDG PET were performed in all 28 patients at ca. 2 weeks and in 23 at 6 months. The tetrofosmin and FDG findings in infarct-related segments were compared with the regional wall motion score assessed by left ventriculography over 6 months to determine the predictive value for functional recovery.
RESULTS:
Of 120 infarct-related segments, 83 had preserved flow (tetrofosmin uptake >/=50%) and 81 had preserved glucose metabolism (FDG uptake >/=40%). The sensitivity and specificity of tetrofosmin SPECT for the prediction of functional recovery tended to be superior to those of FDG PET (90.0% and 72.5% vs 85.0% and 67.5%, respectively). Thirteen segments with preserved flow and decreased glucose metabolism demonstrated marked recovery of contractile function from 2.5+/-1.0 to 1.4+/-1.4 (p<0.01), with restoration of glucose metabolism at 6 months. In contrast, 11 segments with decreased flow and preserved glucose metabolism demonstrated incomplete functional improvement from 3.0+/-0.8 to 2.2+/-1.2.
CONCLUSION:
In the subacute phase, preserved myocardial blood flow is more reliable than glucose metabolism in predicting functional recovery in reperfused myocardium.
AuthorsHaruhisa Shirasaki, Akira Nakano, Hiroyasu Uzui, Yoshiharu Yonekura, Hidehiko Okazawa, Takanori Ueda, Jong-Dae Lee
JournalEuropean journal of nuclear medicine and molecular imaging (Eur J Nucl Med Mol Imaging) Vol. 33 Issue 8 Pg. 879-86 (Aug 2006) ISSN: 1619-7070 [Print] Germany
PMID16586079 (Publication Type: Controlled Clinical Trial, Journal Article)
Chemical References
  • Organophosphorus Compounds
  • Organotechnetium Compounds
  • Radiopharmaceuticals
  • technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane
  • Fluorodeoxyglucose F18
Topics
  • Aged
  • Aged, 80 and over
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction (complications, radionuclide imaging, surgery)
  • Myocardial Reperfusion
  • Organophosphorus Compounds
  • Organotechnetium Compounds
  • Positron-Emission Tomography (methods)
  • Prognosis
  • Radiopharmaceuticals
  • Recovery of Function
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tomography, Emission-Computed, Single-Photon (methods)
  • Treatment Outcome
  • Ventricular Dysfunction, Left (etiology, prevention & control, radionuclide imaging)

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