Brian G Abbott1, Yi-Hwa Liu, James A Arrighi. 1. Division of Cardiology, Brown Medical School, Rhode Island Cardiology Center, Providence, Rhode Island, USA.
Abstract
BACKGROUND: Experimental data have shown that glucose utilization increases during acute myocardial ischaemia, and may persist for up to 24 h. Whether fluorodeoxyglucose (FDG) uptake can be imaged as a memory marker of ischaemia in humans is unknown. METHODS: Patients with mild-to-moderate ischaemia on exercise single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) underwent repeat exercise testing within 1-2 weeks. Positron emission tomography (PET) was performed after injection of FDG 60 min post-exercise. SPECT and PET images were assessed visually, aided by circumferential profile-based analysis modified for 'hot-spot' imaging. RESULTS: Twelve men with stress SPECT ischaemia (mean age, 69 years; nine with known coronary artery disease) were studied. The mean rate-pressure products for the first (SPECT) and second (FDG PET) exercise tests were similar (22,841+/-7321 vs. 22,680+/-7393 mmHg x bpm, P=NS). Overall, six of 12 patients studied had evidence of FDG uptake. The extent of ischaemia on SPECT was similar in FDG positive and FDG negative patients (summed difference score 10.6+/-6.9 vs. 8.0+/-1.6, P=NS). All patients with a positive FDG scan had uptake in either an ischaemic SPECT region or in a territory with known CAD by angiography. CONCLUSION: Regional myocardial uptake of FDG is enhanced even when injected 1 h post-exercise stress in a subset of patients with ischaemia on exercise SPECT MPI. The ability to image FDG uptake injected 1 h after an ischaemic episode suggests the potential utility of FDG as a memory marker of transient ischaemia.
BACKGROUND: Experimental data have shown that glucose utilization increases during acute myocardial ischaemia, and may persist for up to 24 h. Whether fluorodeoxyglucose (FDG) uptake can be imaged as a memory marker of ischaemia in humans is unknown. METHODS:Patients with mild-to-moderate ischaemia on exercise single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) underwent repeat exercise testing within 1-2 weeks. Positron emission tomography (PET) was performed after injection of FDG 60 min post-exercise. SPECT and PET images were assessed visually, aided by circumferential profile-based analysis modified for 'hot-spot' imaging. RESULTS: Twelve men with stress SPECT ischaemia (mean age, 69 years; nine with known coronary artery disease) were studied. The mean rate-pressure products for the first (SPECT) and second (FDG PET) exercise tests were similar (22,841+/-7321 vs. 22,680+/-7393 mmHg x bpm, P=NS). Overall, six of 12 patients studied had evidence of FDG uptake. The extent of ischaemia on SPECT was similar in FDG positive and FDG negative patients (summed difference score 10.6+/-6.9 vs. 8.0+/-1.6, P=NS). All patients with a positive FDG scan had uptake in either an ischaemic SPECT region or in a territory with known CAD by angiography. CONCLUSION: Regional myocardial uptake of FDG is enhanced even when injected 1 h post-exercise stress in a subset of patients with ischaemia on exercise SPECT MPI. The ability to image FDG uptake injected 1 h after an ischaemic episode suggests the potential utility of FDG as a memory marker of transient ischaemia.
Authors: Arthur E Stillman; Matthijs Oudkerk; David Bluemke; Jens Bremerich; Fabio P Esteves; Ernest V Garcia; Matthias Gutberlet; W Gregory Hundley; Michael Jerosch-Herold; Dirkjan Kuijpers; Raymond K Kwong; Eike Nagel; Stamatios Lerakis; John Oshinski; Jean-François Paul; Richard Underwood; Bernd J Wintersperger; Michael R Rees Journal: Int J Cardiovasc Imaging Date: 2010-10-24 Impact factor: 2.357
Authors: Richard M de Jong; Rene A Tio; Pim van der Harst; Adriaan A Voors; Paul M Koning; Clark J A M Zeebregts; Dirk J van Veldhuisen; Rudi A J O Dierckx; Riemer H J A Slart Journal: J Nucl Cardiol Date: 2009-08-01 Impact factor: 5.952