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Myocardial Glucose Utilization and Optimization of ¹⁸F-FDG PET Imaging in Patients with Non–Insulin-Dependent Diabetes Mellitus, Coronary Artery Disease, and Left Ventricular Dysfunction

Cardiac PET Centre, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada

View larger version (72K): [in a new window]   FIGURE 1. Representative midventricular transaxial images obtained with MIBI SPECT perfusion imaging (upper left) and with standard (upper right), insulin clamp (lower left), and niacin (lower right) FDG PET protocols. Each image is normalized to its own maximum. Segmental ROIs on septum (1), apex (2), and lateral wall (3) of perfusion image have been applied to FDG images. Septum was considered to have normal perfusion. rMGU values for each segment are shown at right of image. FDG insulin clamp yielded highest regional rMGUs.

View larger version (27K): [in a new window]   FIGURE 2. Glucose (A), free fatty acid (FFA) (B), and insulin (C) profiles under fasting conditions (black bars) and before (white bars) and after (hatched bars) FDG administration. Free fatty acid: *P < 0.02. Insulin: *P 0.05 vs. fasting; P < 0.001 vs. fasting.

View larger version (18K): [in a new window]   FIGURE 3. Comparison of rMGU among 3 protocols (insulin clamp [black bars], standard [white bars], and niacin [hatched bars]) for segments of different myocardial perfusion. *P < 0.05 for insulin clamp vs. niacin and standard protocols.