BACKGROUND: Of various nuclear medicine techniques, F-18/flourodeoxyglucose (FDG) positron emission tomography (PET) is considered as the best modality for the assessment of viable myocardium (VM). In this study, we compared the diagnostic accuracy of nitrate augmented Tc-99m tetrofosmin gated G-single-photon emission computed tomography (SPECT) with FDG PET. METHODS: 54 consecutive cases of angiographically proven CAD with severe LV dysfunction were enrolled in the study. The patients underwent Tc-99m tetrofosmin G-SPECT and FDG PET as per the standard protocols and were compared. RESULTS: SPECT data analysis indicated functional abnormalities in 661/918 myocardial segments. F-18 FDG PET revealed VM in 496/661 segments. The diagnostic accuracy of baseline NAC, postnitrate NAC, baseline AC, and postnitrate AC Tc-99m tetrofosmin SPECT was 84%, 87%, 90%, and 94%, respectively. κ values for NAC baseline, NAC postnitrate, AC baseline, and AC postnitrate Tc-99m tetrofosmin G-SPECT were 0.65, 0.70, 0.77, and 0.85, respectively. Attenuation correction revealed viability additionally in 46 segments which were non-viable on NAC postnitrate study (P < .001). Nitrate augmentation showed viability additionally in 25 segments which were non-viable on AC baseline scan (P = .004). On patient-based analysis FDG PET changes the management only in 13% (7/54) of patients. CONCLUSIONS: Nitrate augmented AC Tc-99m tetrofosmin G-SPECT shows excellent (κ = .85) agreement with FDG PET. FDG PET changes management only in 13% of the patients. Tc-99m tetrofosmin G-SPECT being more widely available and cheaper imaging modality can be reliably used to detect VM where FDG PET is not available.
BACKGROUND: Of various nuclear medicine techniques, F-18/flourodeoxyglucose (FDG) positron emission tomography (PET) is considered as the best modality for the assessment of viable myocardium (VM). In this study, we compared the diagnostic accuracy of nitrate augmented Tc-99m tetrofosmin gated G-single-photon emission computed tomography (SPECT) with FDG PET. METHODS: 54 consecutive cases of angiographically proven CAD with severe LV dysfunction were enrolled in the study. The patients underwent Tc-99m tetrofosmin G-SPECT and FDG PET as per the standard protocols and were compared. RESULTS: SPECT data analysis indicated functional abnormalities in 661/918 myocardial segments. F-18FDG PET revealed VM in 496/661 segments. The diagnostic accuracy of baseline NAC, postnitrate NAC, baseline AC, and postnitrate AC Tc-99m tetrofosmin SPECT was 84%, 87%, 90%, and 94%, respectively. κ values for NAC baseline, NAC postnitrate, AC baseline, and AC postnitrate Tc-99m tetrofosmin G-SPECT were 0.65, 0.70, 0.77, and 0.85, respectively. Attenuation correction revealed viability additionally in 46 segments which were non-viable on NAC postnitrate study (P < .001). Nitrate augmentation showed viability additionally in 25 segments which were non-viable on AC baseline scan (P = .004). On patient-based analysis FDG PET changes the management only in 13% (7/54) of patients. CONCLUSIONS:Nitrate augmented AC Tc-99m tetrofosmin G-SPECT shows excellent (κ = .85) agreement with FDG PET. FDG PET changes management only in 13% of the patients. Tc-99m tetrofosmin G-SPECT being more widely available and cheaper imaging modality can be reliably used to detect VM where FDG PET is not available.
Authors: K Yoshinaga; K Morita; S Yamada; K Komuro; C Katoh; Y Ito; Y Kuge; T Kohya; A Kitabatake; N Tamaki Journal: J Nucl Med Date: 2001-06 Impact factor: 10.057
Authors: Rob S B Beanlands; Graham Nichol; Ella Huszti; Dennis Humen; Normand Racine; Michael Freeman; Karen Y Gulenchyn; Linda Garrard; Robert deKemp; Ann Guo; Terrence D Ruddy; Francois Benard; André Lamy; Robert M Iwanochko Journal: J Am Coll Cardiol Date: 2007-10-10 Impact factor: 24.094
Authors: I Matsunari; G Böning; S I Ziegler; S G Nekolla; J C Stollfuss; I Kosa; E P Ficaro; M Schwaiger Journal: J Am Coll Cardiol Date: 1998-10 Impact factor: 24.094