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Direct Comparison of Fluorine-18-FDG SPECT, Fluorine-18-FDG PET and Rest Thallium-201 SPECT for Detection of Myocardial Viability

Division of Nuclear Medicine, Department of Radiology, and Division of Cardiology, Richard L. Roudebush Veteran's Affairs Medical Center and Indiana University School of Medicine, Indianapolis, Indiana

Correspondence: For correspondence or reprints contact: Robert W. Burt, MD, Nuclear Medicine Service, 1481 West 10th Street, Indianapolis, IN 46202.

ABSTRACT

Twenty consecutive patients were evaluated for presumptive myocardial viability using rest Tl-SPECT, FDG-PET and FDG-SPECT. The FDG studies were performed after rest Tl-SPECT to guide intervention or medical management. Methods: Twenty patients with proven coronary artery disease, either known or suspected to have previous myocardial infarction and persistent perfusion defects shown by rest reinjection Tl-SPECT, underwent FDG-PET and subsequent FDG-SPECT with a three-detector SPECT camera. FDG-PET and SPECT images were compared by five observers to determine if any fixed thallium segments were visualized by either FDG imaging method. Results: Thirteen of 60 fixed segments were shown probably viable by FDG-SPECT (8 of 20 patients) and 14 of 60 by FDG PET (7 of 20 patients). Two patients had fixed thallium segments found probably viable with FDG by SPECT alone and one by PET alone. Conclusion: FDG is shown to provide additional information about myocardial viability. Both SPECT, using a three-detector camera, and PET with a specialized instrument are equally effective for imaging FDG in this application.

Key Words: fluorodeoxyglucose • SPECT • PET • myocardial viability • thallium

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