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Metabolic activity in the areas of new fill-in after thallium-201 reinjection: comparison with positron emission tomography using fluorine-18-deoxyglucose.

Abstract
Reinjection of thallium-201 after recording the 3-hr delayed scan often demonstrates improvement in areas of persistent abnormalities. To determine the metabolic activity of these areas, the changes seen on stress/redistribution/reinjection thallium SPECT were compared with PET using fluorine-18-fluorodeoxyglucose (FDG) in 18 patients with coronary artery disease. Of 48 segments showing no redistribution on the delayed scan, the reinjection scan identified new fill-in in 20 segments (42%), all of which demonstrated FDG uptake. In contrast, only 7 of the 28 segments (25%) showing no fill-in after reinjection were PET viable (p less than 0.01). Eleven patients had coronary bypass graft surgery after the radionuclide study. The majority of the segments showing redistribution (87%) and new fill-in after reinjection (65%) improved in wall motion, whereas only eight segments (25%) without new fill-in improved after surgery. Of those without new fill-in, two segments showing PET ischemia improved in wall motion, whereas the remaining six segments showing PET scar did not improve after surgery. Thus, the segments showing new fill-in after reinjection are PET viable myocardium. However, reinjection thallium imaging still underestimates the extent of tissue viability compared to PET imaging.
AuthorsN Tamaki, H Ohtani, K Yamashita, Y Magata, Y Yonekura, R Nohara, H Kambara, C Kawai, K Hirata, T Ban
JournalJournal of nuclear medicine : official publication, Society of Nuclear Medicine (J Nucl Med) Vol. 32 Issue 4 Pg. 673-8 (Apr 1991) ISSN: 0161-5505 [Print] United States
PMID2013806 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • Fluorine Radioisotopes
  • Thallium Radioisotopes
  • Fluorodeoxyglucose F18
  • Deoxyglucose
Topics
  • Coronary Circulation (physiology)
  • Coronary Disease (diagnostic imaging, physiopathology)
  • Deoxyglucose (analogs & derivatives)
  • Fluorine Radioisotopes
  • Fluorodeoxyglucose F18
  • Humans
  • Middle Aged
  • Myocardial Contraction (physiology)
  • Myocardium (metabolism)
  • Thallium Radioisotopes (administration & dosage)
  • Tomography, Emission-Computed
  • Tomography, Emission-Computed, Single-Photon

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