[18F]fluorodeoxyglucose single photon emission computed tomography : Can it replace PET and thallium SPECT for the assessment of myocardial viability?

New high-energy collimators for single photon emission computed tomography (SPECT) cameras have made imaging of positron-emitting tracers, such as [18F]fluorodeoxyglucose (18FDG), possible. We examined differences between SPECT and PET technologies and between 18FDG and thallium tracers to determine...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 1998-03, Vol.97 (9), p.843-850
Main Authors: SRINIVASAN, G, KITSIOU, A. N, BACHARACH, S. L, BARTLETT, M. L, MILLER-DAVIS, C, DILSIZIAN, V
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Cardiology. Vascular system
Coronary Disease - diagnostic imaging
Coronary Disease - metabolism
Coronary Disease - physiopathology
Coronary heart disease
Female
Fluorodeoxyglucose F18
Heart
Humans
Male
Medical sciences
Middle Aged
Myocardium - metabolism
Radiopharmaceuticals
ROC Curve
Sensitivity and Specificity
Stroke Volume
Thallium Radioisotopes
Tomography, Emission-Computed
Tomography, Emission-Computed, Single-Photon - methods
Ventricular Dysfunction, Left - diagnostic imaging
Ventricular Dysfunction, Left - metabolism
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Summary:New high-energy collimators for single photon emission computed tomography (SPECT) cameras have made imaging of positron-emitting tracers, such as [18F]fluorodeoxyglucose (18FDG), possible. We examined differences between SPECT and PET technologies and between 18FDG and thallium tracers to determine whether 18FDG SPECT could be adopted for assessment of myocardial viability. Twenty-eight patients with chronic coronary artery disease (mean left ventricular ejection fraction [LVEF]=33+/-15% at rest) underwent 18FDG SPECT, 18FDG PET, and thallium SPECT studies. Receiver operating characteristic curves showed overall good concordance between SPECT and PET technologies and thallium and 18FDG tracers for assessing viability regardless of the level of 18FDG PET cutoff used (40% to 60%). However, in the subgroup of patients with LVEF< or =25%, at 60% 18FDG PET threshold value, thallium tended to underestimate myocardial viability. In a subgroup of regions with severe asynergy, there were considerably more thallium/18FDG discordances in the inferior wall than elsewhere (73% versus 27%, P
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.97.9.843