ASSESSMENT OF SKELETAL-MUSCLE VIABILITY BY PET

We investigated the use of [F-18]fluoro-2-deoxyglucose (FDG) PET scann ing for assessment of skeletal muscle viability in patients with perip heral vascular disease and in patients following free-flap skeletal mu scle transfer for closure of open wounds. Methods: We obtained 32 FDG- PET scans from 30 patients, either at the time of admission for periph eral vascular disease (n = 16) or between 1 and 15 days after surgery for skeletal muscle transfer (n = 16). Ratios between injured and cont ralateral limb FDG tracer activity uptake were correlated with clinica l outcome at 1 mo to 3 yr follow-up. Results: Viable muscle uptake rat ios ranged from 0.47 to 7.88 (mean: 2.26 +/- 1.81; n = 26), while nonv iable muscle uptake ratios ranged from 0.12 to 0.46 (mean: 0.27 +/- 0. 12; n = 6; p < 0.02). After skeletal muscle transfer, two patients wit h viable tissue, as documented. by PET, required amputation due to ost eomyelitis, and one patient with peripheral vascular disease who showe d viable tissue by PET required amputation 3 mo after the PET scan bec ause of recurrent ulcers. Conclusion: FDG-PET scanning can determine s keletal muscle viability in patients with peripheral vascular disease and in patients following free-flap transfer.