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Comparative assessment of18F-fluorodeoxyglucose PET and99mTc-tetrofosmin SPECT for the prediction of functional recovery in patients with reperfused acute myocardial infarction

  • Haruhisa Shirasaki
  • Akira NakanoEmail author
  • Hiroyasu Uzui
  • Yoshiharu Yonekura
  • Hidehiko Okazawa
  • Takanori Ueda
  • Jong-Dae Lee
Original article

Abstract

Purpose: 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 of99mTc-tetrofosmin SPECT and18F-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.

Keywords

Reperfused myocardium Myocardial viability 99mTc tetrofosmin 18F fluorodeoxyglucose 

Notes

Acknowledgements

We would like to thank Katsuya Sugimoto and Hiroshi Fujibuchi for their technical assistance in performing SPECT and PET.

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Haruhisa Shirasaki
    • 1
  • Akira Nakano
    • 1
    Email author
  • Hiroyasu Uzui
    • 1
  • Yoshiharu Yonekura
    • 2
  • Hidehiko Okazawa
    • 2
  • Takanori Ueda
    • 1
  • Jong-Dae Lee
    • 1
  1. 1.First Department of Internal Medicine, Faculty of Medical SciencesUniversity of FukuiMatsuoka, Eiheiji-cho, FukuiJapan
  2. 2.Biomedical Imaging Research Center, Faculty of Medical SciencesUniversity of Fukui, Eiheiji-choFukuiJapan

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