Comparison of myocardial uptake of fluorine-18-fluorodeoxyglucose imaged with PET and SPECT in dyssynergic myocardium

PET with F-18-fluorodeoxyglucose (FDG) can detect viable myocardium and predict functional recovery after revascularization. The use of PET for clinical routine, however, is limited. Recently, imaging FDG with SPECT was proposed. The aim of this study was to compare the diagnostic value of FDG-PET and FDG-SPECT in the detection of viable myocardium in segments with abnormal wall motion, Methods: Twenty patients with previous myocardial infarction were studied. All underwent FDG-PET and FDG-SPECT during hyperinsulinemic glucose clamping. Regional perfusion was assessed with N-13-ammonia PET and early resting Tl-201- SPECT. Regional wall motion was assessed with two-dimensional echocardiography, The agreement between FDG/N-13-ammonia PET and FDG/Tl-201 SPECT to detect viability in dyssynergic myocardium was 76%. On a patient basis, PET and SPECT yielded comparable results in 17 of 20 patients. In a subgroup of patients with LVEF less than or equal to 35% (n = 12), all PET and SPECT viability data were identical. Conclusion: This study shows a good correlation between the detection of viability in dyssynergic myocardium with FDG/N-13-ammonia PET and FDG/Tl-201 SPECT, both On a Segmental and patient basis.