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Hybrid PET-CT Evaluation of Myocardial Viability

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Hybrid Cardiac Imaging

Abstract

In patients with ischemic cardiomyopathy, the likelihood of recovery of left ventricular function after coronary revascularization depends on the presence and extent of myocardial viability. Evaluation of myocardial glucose metabolism by 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is a commonly used method for the assessment of myocardial viability. Preserved glucose metabolism indicates the presence of viable myocardium even in segments with reduced resting perfusion (perfusion-metabolism mismatch). Viability assessment by FDG PET has particularly high sensitivity for prediction of functional recovery after revascularization. Evidence from observational/retrospective data demonstrated that in ischemic cardiomyopathy patients with myocardial viability detected by PET, revascularization was associated with reduced mortality rates, compared with medical treatment, whereas in those without viability, mortality rates were not significantly different by treatment modality. Limited evidence from randomized data suggests that PET-guided management, versus standard care, was associated with reduction of composite adverse outcome only in the subgroup of patients who adhered to PET recommendations. This article summarizes the principles and methodological aspects as well as clinical data on the value of FDG PET in evaluation of myocardial viability.

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Authors and Affiliations

  1. Heart Center, Turku University Hospital, Turku, Finland

    Wail Nammas & Antti Saraste

  2. PET Centre, Turku University Hospital, Turku, Finland

    Wail Nammas & Antti Saraste

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  1. Wail Nammas
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  2. Antti Saraste
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Correspondence to Antti Saraste .

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Editors and Affiliations

  1. Department of Nuclear Medicine, Technical University Munich, Munich, Germany

    Stephan G. Nekolla

  2. Department of Nuclear Medicine, University of Duisburg-Essen, Essen, Nordrhein-Westfalen, Germany

    Christoph Rischpler

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Nammas, W., Saraste, A. (2022). Hybrid PET-CT Evaluation of Myocardial Viability. In: Nekolla, S.G., Rischpler, C. (eds) Hybrid Cardiac Imaging. Springer, Cham. https://doi.org/10.1007/978-3-030-83167-7_9

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