Preoperative Correction of Tc-99-m-MIBI SPECT by F¹⁸-FDG Cardiac PET/CT for Myocardial Viability Before CABG

Abstract

Objectives: Coronary artery bypass graft (CABG)surgery has been safely practiced on cases with poor left ventricular ejection fraction (LVEF). Although adversely effects of surgery with higher mortality and morbidity rates, preoperative myocardial viability defines outcome. Thus, it is crucial to determine preoperative left ventricular myocardial tissue viability for acceptable postoperative results in this group of patients. This multi-center prospective study focuses of assessment of myocardial perfusion and viability by comparison of two different nuclear medicine imaging techniques; technetium 99-m-methoxy-isobutyl-isonitrile single photon emission computed tomography (Technetium-99-m-MIBI SPECT) and cardiac fluorodeoxyglucose positron emission tomography-computed tomography (F 18 -FDG Cardiac PET/CT). Materials and Methods:Study is performed by ethical approval and Helsinki protocols. Each patient was evaluated by Technetium-99-m-MIBI SPECT and F 18 -FDG Cardiac PET/CT for myocardial viability detection prior to CABG surgery. Technetium-99-m-MIBI SPECT and F 18 -FDG Cardiac PET/CT was evaluated in 191 cases preoperatively. These 191 cases (mean age 64±9.1 and male n=103, 53.9%) with LVEF ≤35% were evaluated for coronary revascularization preoperatively.Results: Study data accumulated from cases of CABG (n=191) with preoperative LVEF measurements between 35% to 20% (n=154, 80.6%) and lower than 20% (n=37, 19.3%). Technetium-99-m-MIBI SPECT imaging was performed before F 18 -FDG Cardiac PET/CT in all cases. By these evaluations, 1896 segments were detailed in total. For Technetium-99-m-MIBI SPECT, 1036 segments displayed normal Technetium-99-m-MIBI uptake (≥70%, classification 2). On the other hand, 860 segments displayed reduced Technetium-99-m-MIBI uptake with Abstract Research Article