DIRECT COMPARISON OF FLUORINE-18-FDG SPECT, FLUORINE-18-FDG PET AND REST TL-201 SPECT FOR DETECTION OF MYOCARDIAL VIABILITY

Twenty consecutive patients were evaluated for presumptive myocardial viability using rest TI-SPECT, FDG-PET and FDG-SPECT. The FDG studies were performed after rest TI-SPECT to guide intervention or medical ma nagement. 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 TI-SPECT, unde rwent FDG-PET and subsequent FDG-SPECT with a three-detector SPECT cam era. FDG-PET and SPECT images were compared by five observers to deter mine if any fixed thallium segments were visualized by either FDG imag ing 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 i s 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.