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Semiquantitative Assessment of Myocardial Blood Flow and Viability Using Polar Map Displays of Cardiac PET Images

Division of Nuclear Medicine and Biophysics, Department of Radiological Sciences, UCLA School of Medicine University of California, Los Angeles, California
Laboratory of Nuclear Medicine, Laboratory of Biomedical and Environmental Sciences, University of California, Los Angeles, California

Correspondence: For reprints contact: Heinrich A. Schelbert, MD., Division of Nuclear Medicine and Biophysics, UCLA School of Medicine, Los Angeles, CA 90024-1721.

ABSTRACT

Preserved glucose metabolism in ischemically injured, dysfunctional myocardial tissue as demonstrated on PET imaging predicts functional improvement after revascularization. To characterize more precisely the relationship between regional myocardial blood flow, viability and extent and severity of flow and metabolism abnormalities, we developed a PC-based semiquantitative analysis technique using ¹³N-ammonia and ¹⁸F-deoxyglucose polar map displays. A data base for mean values (m) and standard deviations (s.d.) for relative ¹³N activities reflecting regional myocardial blood flow, relative ¹⁸F activities normalized to normal flow regions reflecting regional glucose utilization and the difference of normalized ¹⁸F and ¹³N activities as an index of a flow-metabolism mismatch was established in 11 normals. Parametric polar maps were derived by comparing patient data to a normal range defined as > – 2 s.d. for relative myocardial blood flow and <m + 2 s.d. for both relative glucose utilization and the difference between normalized ¹⁸F and ¹³N activities. Semiquantitative indices of extent and severity of blood flow defects, of relative increases in glucose utilization and of flow-metabolism mismatch areas are generated for the entire myocardium and the three coronary territories. The approach promises to be clinically useful to confirm presence and absence of flow and metabolic abnormalities and to assess their extent as a potential predictor of functional outcome after therapy.

FOOTNOTES

^* Operated for the U.S. Department of Energy by the University of California under contract #DE-FC03-87ER60615.

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