Assessment of acute thrombolysis with newly developed myocardial single-photon emission computed tomographic techniques

Conclusion

Freeze imaging allows simultaneous evaluation of the area at risk and salvaged myocardium. It is also useful for determining the indication for emergency reperfusion therapy from the extent and degree of the defect at the time of administration before thrombolysis or primary angioplasty. In contrast, memory imaging provides diagnostic information on various tracers, which, dependent on the tracer, is different from that of myocardial perfusion. Thus detailed properties of the infarcted myocardium may be assessed from the memory image.

These new tracers provide the same information on the whole, although each has slightly different characteristics. It remains unsolved which tracer is the most useful for the evaluation of reperfusion therapy or the outcome of the therapy. However, at least one of these imagings should be incorporated actively by nuclear cardiologists.

Nuclear cardiology has excellent characteristics that allow imaging of perfusion, necrosis, metabolism, and receptors, which are different from those of echocardiography, x-ray computed tomography, and magnetic resonance imaging, and a low assessment of new clinical conditions that will appear as new therapeutic methods are developed. When used appropriately, these procedures can significantly improve the use of reperfusion therapy by defining indications in particular patient subgroups, observing the course of therapeutic efficacy, and evaluating porttherapy prognosis and other outcomes.