Practical assessment of myocardial viability with a positron coincidence gamma camera using 18F-fluorodeoxyglucose in acute myocardial infarction: Comparison with dedicated positron emission tomography and 201Tl single photon emission computed tomography

Objective: 2-[F-18] fluoro-2-deoxy-D-glucose (F-18-FDG) began to be supplied commercially to our hospital, which does not have a cyclotron, in autumn of 2005. The purpose of this study was to compare the utility of a dual-head positron coincidence detection (PCD) gamma camera in the detection of myocardial viability using F-18-FDG with that of dedicated positron emission tomography (PET) and with that of thalium-201 (Tl-201) single photon emission computed tomography (SPECT). Methods: A total of 15 patients (14 men and 1 woman, mean age: 60 +/- 7 years, range: 46-73) with a large acute myocardial infarction (AMI) underwent F-18-FDG PET, F-18-FDG PCD imaging after oral glucose loading (75 g) and Tl-201 SPECT imaging. We divided the SPECT and PET images into a total of 20 segments, and semiquantitative visual analysis was performed by assessing regional tracer activities on a 4-point scoring system (DS): 0 = normal uptake, 1 = mildly reduced uptake, 2 = severely reduced uptake, and 3 = no uptake. We summed the DS in each patient as the total DS (TDS). Results: The TDS of the F-18-FDG PET image was 14.4 +/- 7.7. The TDS of the F-18-FDG PCD image was 18.7 +/- 7.7. The TDS of the Tl-201 SPECT image was 24.1 +/- 11.5. The TDS of the F-18-FDG PET image was significantly smaller than that of the F-18-FDG PCD image. The TDS of the F-18-FDG PET image was significantly smaller than that of the Tl-201 SPECT image. The TDS of the F-18-FDG PCD image was significantly smaller than that of the Tl-201 SPECT image. Conclusion: The findings of the project suggest that F-18-FDG PCD is a good modality based on its accuracy, convenience, and cost-performance for detecting myocardial viability in hospitals that do not have a PET system. (C) 2009 Japanese College of Cardiology. Published by Elsevier Ireland Ltd. All rights reserved.