How Should Myocardial Viability Be Assessed by<sup> 18</sup>F-Fluoro-2-Deoxyglucose Positron Emission Tomography?

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  • Momose Mitsuru
    Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women’s Medical University

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  • Serial Changes in Glucose-Loaded <sup>18</sup>F-Fluoro-2-Deoxyglucose Positron Emission Tomography, <sup>99m</sup>Tc-Tetrofosmin and <sup>123</sup>I-Beta-Methyl-p-Iodophenyl-Penta-Decanoic Acid Myocardial Single-Photon Emission Computed Tomography Images in Patients With Anterior Acute Myocardial Infarction

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Background:18F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) is assumed to be the most useful method for evaluating the viability of the myocardium. However, there are few reports regarding serial changes in 18F-FDG-PET images of acute myocardial infarction (AMI). We evaluated serial changes in glucose-loaded 18F-FDG-PET, 123I-β-methyl-p-iodophenyl-penta-decanoic acid (BMIPP) single-photon emission computed tomography (SPECT) and 99mTc-Tetrofosmin (TF) gated SPECT images in patients with AMI. Methods and Results: We enrolled 7 consecutive patients with first anterior AMI who successfully underwent percutaneous coronary intervention (PCI). 18F-FDG-PET images were obtained in the acute, subacute, chronic, mid-term and long-term phases. 123I-BMIPP and 99mTc-TF SPECT images were obtained in the subacute, chronic, mid-term and long-term phases. We determined the total defect score (TDS) for each image. The TDS of the glucose-loaded 18F-FDG-PET, 123I-BMIPP and 99mTc-TF SPECT images indicated significant serial decrease (P<0.001). Comparing these images, the TDS of the glucose-loaded 18F-FDG-PET images was larger than that of the 123I-BMIPP and 99mTc-TF SPECT images, and the TDS indicated 18F-FDG-PET>123I-BMIPP>99mTc-TF in all phases. Conclusions: The defect areas of glucose-loaded 18F-FDG-PET images were significantly larger than those of 123I-BMIPP and 99mTc-TF SPECT images during 9 months follow-up of patients with successful PCI for anterior AMI. Additionally, the impairment of glucose metabolism was prolonged.  (Circ J 2013; 77: 137–145)<br>

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