Abstract
Treatment of patients with coronary artery disease (CAD) and evidence of ischemia is an important clinical issue. Patients benefit from revascularization if viable or jeopardized myocardium is present. Various myocardial perfusion imaging techniques with different radioisotopes [thallium-201, 99mTc (technetium-99m)-sestamibi, 13N (nitrogen-13)- ammonia, 18F-fluoro-deoxyglucose (FDG)] have been proven to delineate myocardium that shows functional recovery after revascularization 1-9. Dobutamine stress echocardiography is also used to detect myocardium that could benefit from revascularization 10. However, for all these techniques varying numbers for sensitivity and specificity for recovery of left ventricular function are reported. This has also been demonstrated in a recent meta-analysis 11. Stress/rest sestamibi single photon emission computed tomography (SPECT) imaging is a widely used technique to detect myocardial perfusion abnormalities. In revascularization strategies, sestamibi SPECT results are frequently used to demonstrate whether viable myocardium with stress induced ischemia is present. For prediction of recovery of left ventricular function good sensitivity and specificity have been reported 11. Nitrogen-ammonia/FDG positron emission tomography (PET) myocardial perfusion imaging is used for detection of hibernating myocardium and/or stress induced ischemia. Since FDG imaging represents myocardial glucose metabolism, PET is thought to detect viability better than sestamibi SPECT. Moreover PET imaging has a higher resolution and higher energy emission voltage resulting in better image quality.
Keywords
- Positron Emission Tomography
- Single Photon Emission Compute Tomography
- Positron Emission Tomography Imaging
- Single Photon Emission Compute Tomography Imaging
- Wall Motion Score Index
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Tamaki N, Kawamoto M, Takahashi N, et al. Prognostic value of an Increase in fuorine-18 deoxyglucose uptake in patients with myocardial infarction: comparison with stress thallium imaging. J Am Coll Cardiol 1993; 22:1621–7
Knuuti MJ, Sarraste M, Nuutila P, et al. Myocardial viability: fluorine-18-deoxyglucose positron emission tomography in prediction of wall motion recovery after revascularization. Am Heart J 1994; 127:785–96
Beller GA, Ragosta M, Watson DD, Gimple LW. Myocardial thallium-201 scintigraphy for assessment of viability in patients with severe left ventricular dysfunction. Am J Cardiol 1992; 70:18E–22E.
Tillisch J, Brunken R, Marshall R, et al. Reversibility of cardiac wall motion abnormalities predicted by positron tomography. N Engl J Med 1986; 314:884–8.
Soufer R, Dey HM, Ng CK, Zaret BL. Comparison of sestamibi single photon emission computed tomography with positron emission tomography for estimating left ventricular myocardial viability. Am J Cardiol 1995; 75:1214–9.
Bax JJ, Cornel JH, Visser FC, et al. Prediction of improvement of contractile function in patients with ischemic ventricular dysfunction after revascularization by fluorine-18 fluorodeoxyglucose single photon emission Computed Tomography. J Am Coll Cardiol 1997; 30:377–83.
Tamaki N, Ohanti H, Yamashita K, et al. Metabolic activity in the areas of new fill-in after thallium-201 reinjection: comparison with positron emission tomography using fluorine-18-deoxyglucose. J Nucl Med 1991; 32:673–8.
Tamaki N, Kawamoto M, Tadamura E, et al. Prediction of reversible ischemia after revascularization. Perfusion and metabolic studies with positron emission tomography. Circulation 1995; 91:1697–705.
Vom Dahl J, Eitzman DT, Al-Aouar ZR, et al. Relation of regional function, perfusion and metabolism in patients with advanced coronary artery disease undergoing surgical revascularization. Circulation 1994; 90:2356–66.
Afridi I, Kleiman NS, Raizner AE, Zoghbi WA. Dobutamine echocardiography in myocardial hibernation. Optimal dose and accuracy in predicting recovery of ventricular function after coronary angioplasty. Circulation 1995; 91:663–70.
Bax JJ, Wijns W, Cornel JH, Visser FC, Boersma E, Fioretti PM. Accuracy of currently available techniques for prediction of functional recovery after revascularization in patients with left ventricular dysfunction due to chronic coronary artery disease: comparison of pooled data. J Am Coll Cardiol 1997; 30:1451–60.
Breekland A, Blanksma PK, Kengen RA, Pieper EG, Crijns HJ, Visser CA. Categorization of abnormal left ventricular function: comparison between radionuclide angiographic and echocardiographic technique in postinfarction patients. Am J Cardiol 1997; 79:108–11.
Huang SC, Phelps ME, Hoffman EJ, Sideris K, Selin CJ, Kuhl DE. Noninvasive determination of local cerebral metabolic rate of glucose in man. Am J Physiol 1980; 238:E69–82.
Ratib O, Phelps ME, Huang SC, Henze E, Selin CE, Schelbert HR. Positron tomography with deoxyglucose for estimating local myocardial glucose metabolism. J Nucl Med 1982; 23:577–86.
Knuuti MJ, Nuutila P, Ruotsalainen U, et al. Euglycemic hyperinsulinemic clamp and oral glucose load in stimulating myocardial glucose utilization during positron emission tomography. J Nucl Med 1992; 33:1255–62.
Blanksma PK, Willemsen AT, Meeder JG, et al. Quantitative myocardial mapping of perfusion and metabolism using parametric polar map displays in cardiac PET. J Nucl Med 1995; 36:153–8.
Shelbert HR, Phelps ME, Huang SC, et al. N-13 ammonia as an indicator of myocardial blood flow. Circulation 1981; 63:1259–72.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1998 Springer Science+Business Media New York
About this chapter
Cite this chapter
Siebelink, HM.J., van Boven, A.J., Blanksma, P.K. (1998). Improvement of LV Function by a PET based Revascularization Strategy: A Prospective Randomized Comparison with SPECT. In: Van Der Wall, E.E., Blanksma, P.K., Niemeyer, M.G., Vaalburg, W., Crijns, H.J.G.M. (eds) Advanced Imaging In Coronary Artery Disease. Developments in Cardiovascular Medicine, vol 202. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-0866-2_14
Download citation
DOI: https://doi.org/10.1007/978-94-007-0866-2_14
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-010-3746-4
Online ISBN: 978-94-007-0866-2
eBook Packages: Springer Book Archive