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

Shirasaki, Haruhisa; Nakano, Akira; Uzui, Hiroyasu; Yonekura, Yoshiharu; Okazawa, Hidehiko; Ueda, Takanori; Lee, Jong–Dae

doi:10.1007/s00259-006-0071-0

Cited by 13 publications

(7 citation statements)

References 23 publications

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“…We have provided further insights into the definition and performance of LGE and FDG to detect viability in the acute setting, using the FDG uptake on the corresponding follow-up scan as gold standard. Shirasaki et al 34 has previously suggested a cut-off of 40% to detect viable myocardium, but FDG PET imaging was performed 2 weeks post AMI, and they used segmental wall motion recovery as the definition for viability. Rischpler et al 8 used a cut-off of ≥50% in the acute setting but no follow-up FDG PET was performed for comparison.…”

Section: Discussionmentioning

confidence: 99%

Quantifying the Area at Risk in Reperfused ST-Segment–Elevation Myocardial Infarction Patients Using Hybrid Cardiac Positron Emission Tomography–Magnetic Resonance Imaging

Bulluck

White

Fröhlich

et al. 2016

Circ: Cardiovascular Imaging

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In the first few days after an acute ST-segment-elevation myocardial infarction (STEMI), cardiac magnetic resonance (MR) imaging can assess regional/global left ventricular function, myocardial infarction (MI) size, the area at risk (AAR), 1,2 the presence of microvascular obstruction (MVO), 3 and intramyocardial hemorrhage 4 -features which not only provide important prognostic information but may also serve as surrogate end points in cardioprotection studies. These omit a key biological parameter, cardiac metabolism, currently inaccessible by conventional MR imaging. See Editorial by Schwaiger See Clinical PerspectiveThe recent availability of hybrid positron emission tomography and magnetic resonance (PET-MR) imaging offers the unique advantage of simultaneous tissue characterization by Background-Hybrid positron emission tomography and magnetic resonance allows the advantages of magnetic resonance in tissue characterizing the myocardium to be combined with the unique metabolic insights of positron emission tomography. We hypothesized that the area of reduced myocardial glucose uptake would closely match the area at risk delineated by T2 mapping in ST-segment-elevation myocardial infarction patients. Methods and Results-Hybrid positron emission tomography and magnetic resonance using 18 F-fluorodeoxyglucose (FDG) for glucose uptake was performed in 21 ST-segment-elevation myocardial infarction patients at a median of 5 days. Follow-up scans were performed in a subset of patients 12 months later. The area of reduced FDG uptake was significantly larger than the infarct size quantified by late gadolinium enhancement (37.2±11.6% versus 22.3±11.7%; P<0.001) and closely matched the area at risk by T2 mapping (37.2±11.6% versus 36.3±12.2%; P=0.10, R=0.98, bias 0.9±4.4%). On the follow-up scans, the area of reduced FDG uptake was significantly smaller in size when compared with the acute scans (19.5 [6.3%-31.8%] versus 44.0 [21.3%-55.3%]; P=0.002) and closely correlated with the areas of late gadolinium enhancement (R 0.98) with a small bias of 2.0±5.6%. An FDG uptake of ≥45% on the acute scans could predict viable myocardium on the follow-up scan. Both transmural extent of late gadolinium enhancement and FDG uptake on the acute scan performed equally well to predict segmental wall motion recovery. Conclusions-Hybrid positron emission tomography and magnetic resonance in the reperfused ST-segment-elevation myocardial infarction patients showed reduced myocardial glucose uptake within the area at risk and closely matched the area at risk delineated by T2 mapping. FDG uptake, as well as transmural extent of late gadolinium enhancement, acutely can identify viable myocardial segments. (Circ Cardiovasc Imaging. 2016;9:e003900.

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Section: Discussionmentioning

confidence: 99%

Quantifying the Area at Risk in Reperfused ST-Segment–Elevation Myocardial Infarction Patients Using Hybrid Cardiac Positron Emission Tomography–Magnetic Resonance Imaging

Bulluck

White

Fröhlich

et al. 2016

Circ: Cardiovascular Imaging

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“…While little is known about the exact mechanism and the consequences of the normal perfusion-hypo-metabolized myocardium-reverse mismatch, some studies showed that reversed mismatch represents a viable myocardium, while others indicated its association with severe disease and non-transmural infarction. [18][19][20][21] The balance of myocardial metabolism is tightly regulated and depends on multiple factors including availability of nutrient, myocardial pathology, circulating hormones, and insulin resistance. Adequate shifting of myocardial metabolism from free fatty acid to glucose should be considered when interpreting a viability study, particularly in the present study and the applied protocol.…”

Section: See Related Article Pp 269-279mentioning

confidence: 99%

Is having a sweetheart enough to survive?

Massalha

Slart

2020

Journal of Nuclear Cardiology

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“…In a recent study, Shirasaki et al. (76) compared Tc‐99m tetrofosmin SPECT and F‐18 FDG PET for the prediction of functional recovery in reperfused AMI. In 28 revascularized patients PET and SPECT studies were conducted in the subacute (17 ± 4 and 15 ± 4 days respectively) and in the chronic phase (6 months later).…”

Section: Fdg‐pet In Acs Ami and Chronic Cadmentioning

confidence: 99%

Cardiac Imaging in Acute Coronary Syndromes and Acute Myocardial Infarction – An Update

2006

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Summary Myocardial perfusion imaging (MPI) using nuclear techniques is a well‐established diagnostic tool in the management of patients after acute coronary syndromes (ACS) or acute myocardial infarction (AMI) providing non‐invasively information about perfusion and function. Single photon emission computed tomography (SPECT) is routinely applied for MPI allowing the characterization of localization, extent and severity of perfusion abnormalities. Gated SPECT MPI is a technique that can accurately define the individual patient risk among clinically stable survivors of AMI, assessing the total left ventricular (LV) perfusion defect size, the extent of inducible ischaemia and the degree of LV dysfunction. The documented prognostic value of these scintigraphic parameters is of clinical importance to guide decision making in the cardiac patient. Moreover, the cost effectiveness of implemented MPI in the work‐up of patients after AMI has been demonstrated. Metabolic imaging with F‐18 deoxyglucose positron emission tomography (PET) is currently the most advanced scintigraphic imaging technique developed for in vivo assessment of tissue viability, providing clinical valuable information about the presence and extent of viable myocardium in patients with coronary artery disease. Whether this technique will be valuable for patients with ACS or AMI has not been established, yet. However, PET technology offers fascinating opportunities to investigate the distinct pathophysiological pathways in acute and chronic cardiac disease. Imaging of stunning in Takotsubo cardiomyopathy is an example of how nuclear medicine techniques contribute to the understanding of cardiac disease.

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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

Abstract: In the subacute phase, preserved myocardial blood flow is more reliable than glucose metabolism in predicting functional recovery in reperfused myocardium.

Cited by 13 publications

References 23 publications

Quantifying the Area at Risk in Reperfused ST-Segment–Elevation Myocardial Infarction Patients Using Hybrid Cardiac Positron Emission Tomography–Magnetic Resonance Imaging

Quantifying the Area at Risk in Reperfused ST-Segment–Elevation Myocardial Infarction Patients Using Hybrid Cardiac Positron Emission Tomography–Magnetic Resonance Imaging

Is having a sweetheart enough to survive?

Cardiac Imaging in Acute Coronary Syndromes and Acute Myocardial Infarction – An Update

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